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Take Home Ration Under ICDS: How Much and For Whom? Indian Pediatr 2022. [DOI: 10.1007/s13312-022-2552-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Jennings EA, Farrell MT, Kobayashi LC. Grandchild Caregiving and Cognitive Health Among Grandparents in Rural South Africa. J Aging Health 2021; 33:661-673. [PMID: 33788664 PMCID: PMC8416744 DOI: 10.1177/08982643211006592] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: We investigate how caregiving for grandchildren is associated with cognitive function among rural South Africans, and whether the association differs by gender. We further investigate whether measures of physical activity or social engagement mediate this association. Methods: Data were from interviews with 3668 Black, South African grandparents in the "Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa" study, conducted between 2014 and 2015. Results: We find that caregiving grandparents have better cognitive function than non-caregiving grandparents, and this association does not differ by grandparent gender. Although grandchild caregiving is associated with physical activity and social engagement measures, and some of these measures are associated with cognitive function, we do not find conclusive evidence of mediation. Discussion: Providing care for grandchildren may stimulate cognitive function for both grandmothers and grandfathers. Neither physical activity nor social engagement explains the association between caregiving and cognitive function.
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Affiliation(s)
- Elyse A. Jennings
- Harvard Center for Population and Development Studies, Harvard T H. Chan School of Public Health, Boston, MA, USA
| | - Meagan T. Farrell
- Harvard Center for Population and Development Studies, Harvard T H. Chan School of Public Health, Boston, MA, USA
| | - Lindsay C. Kobayashi
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Schatz E, David I, Angotti N, Gómez-Olivé FX, Mojola SA. From "Secret" to "Sensitive Issue": Shifting Ideas About HIV Disclosure Among Middle-Aged and Older Rural South Africans in the Era of Antiretroviral Treatment. J Aging Health 2021; 34:14-24. [PMID: 34027688 DOI: 10.1177/08982643211020202] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE As HIV shifts from "death sentence" to "chronic condition," disclosure of HIV status to intimate partners and family is a significant component of both prevention and treatment adherence. While disclosure is closely considered in many studies, few examine middle-aged and older persons' (age 40+) perspectives or practices. We trace older rural South Africans' views on HIV disclosure to their partners and family members in a high prevalence community over a period of extensive antiretroviral treatment (ART) rollout. METHODS Community focus group discussions (FGD) conducted in 2013 and 2018 show shifts in older persons' thinking about HIV disclosure. FINDINGS Our FGD participants saw fewer negative consequences of disclosure in 2018 than in 2013, and highlighted positive outcomes including building trust (partners) as well as greater support for medication collection and adherence (family). DISCUSSION Particularly as the epidemic ages in South Africa and globally, tracing changes in older persons' views on disclosure is an important step in developing messaging that could enhance treatment as prevention and ART adherence.
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Affiliation(s)
- Enid Schatz
- University of Missouri14716, Columbia, MO, USA.,37708MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Nicole Angotti
- 37708MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,8363American University, Washington, DC, USA
| | - F Xavier Gómez-Olivé
- 37708MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sanyu A Mojola
- 37708MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,6740Princeton University, Princeton, NJ, USA
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Audet CM, Clemens EM, Ngobeni S, Mkansi M, Sack DE, Wagner RG. Throwing the bones to diagnose HIV: Views of rural South African traditional healers on undertaking HIV counselling and testing. AIDS Care 2020; 33:1316-1320. [PMID: 32799661 DOI: 10.1080/09540121.2020.1808568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In 2018, nearly 800,000 HIV positive individuals in South Africa were unaware of their status. Traditional healers see patients who avoid health clinics, including those who refuse HIV testing. This manuscript details the results of a qualitative study to understand traditional healer perspectives on performing healer-initiated HIV counseling and testing HIV in rural South Africa. We conducted 30 structured in-depth interviews between April and June 2019 to elicit traditional healer attitudes towards partnering with local health services to perform HIV counseling and testing with their patients. Healers reported that while some patients are open about their HIV status, others lie about it due to stigma. This creates challenges with concurrent treatment, which healers believe leads to allopathic and/or traditional medication treatment failure. Most healers expressed both an interest and a willingness to perform HIV counseling and testing. Healers felt that by performing testing in the community, it would overcome issues related to HIV stigma, as well as a lack of confidentiality and trust with health care workers at the clinic. Trained traditional healers may be able to bridge the testing gap between "non-testers" and the allopathic health system, essentially "opening" thousands of new testing locations with little financial investment.
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Affiliation(s)
- Carolyn M Audet
- Department of Health Policy, Vanderbilt University Medical Center, School of Medicine, Vanderbilt University, Nashville, USA
| | - Elise M Clemens
- Department of Health Policy, Vanderbilt University Medical Center, School of Medicine, Vanderbilt University, Nashville, USA
| | - Sizzy Ngobeni
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mevian Mkansi
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Daniel E Sack
- Department of Health Policy, Vanderbilt University Medical Center, School of Medicine, Vanderbilt University, Nashville, USA
| | - Ryan G Wagner
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Horvath KJ, Walker T, Mireles L, Bauermeister JA, Hightow-Weidman L, Stephenson R. A Systematic Review of Technology-Assisted HIV Testing Interventions. Curr HIV/AIDS Rep 2020; 17:269-280. [PMID: 32507984 PMCID: PMC7276280 DOI: 10.1007/s11904-020-00506-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to describe and assess the literature on mobile health (mHealth) and other technology-based HIV testing interventions published in the 5-year period from 2015 to 2020. RECENT FINDINGS We identified 18 published technology-based studies, 6 of which were efficacy trials and the remaining 12 were either pilot randomized controlled trials (RCTs) or quasi-experimental studies. Most (n = 10) interventions were conducted outside the USA, including countries in Sub-Saharan Africa (n = 4), China (n = 3), Latin America (n = 2), and India (n = 1). All efficacy trials showed some evidence of efficacy, although uptake of HIV testing was low among in intervention trials that consisted of a low number of text messages. Most pilot RCTs demonstrated high levels of feasibility and acceptability, as well as some evidence that the intervention participants benefited more than the control group. Many non-randomized trials similarly reported positive appraisal by study participants. Recommendations for future research and practice by the authors of the studies reviewed here are summarized. Technology-assisted HIV testing interventions may be an important strategy to reach national and global targets for HIV status awareness in the general population and for most at-risk groups. Although there appears to be growing evidence of their benefit, questions linger regarding how to leverage existing social media platforms to promote HIV testing, which interventions work for what populations, and best practices for scaling up mHealth and other technology-based interventions.
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Affiliation(s)
- Keith J Horvath
- Department of Psychology, San Diego State University, San Diego, CA, USA.
| | - Teresa Walker
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Linda Mireles
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | | | - Lisa Hightow-Weidman
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rob Stephenson
- Center for Sexuality and Health Disparities, and the School of Nursing, University of Michigan, Ann Arbor, MI, USA
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Abstract
By April 2020, COVID-19 lockdowns had restricted the movements of over half the world's population. As health authorities advise people living with chronic conditions to self-isolate because they are at particular risk of serious complications and death, the epidemiological split between communicable and noncommunicable disease is tenuous. We argue that much more is at stake for people living with (multiple) medical conditions than being "at risk" of infection of coronavirus. We emphasize the need to attend to the long-term effects of COVID-19, but also the importance of the continued care of people living with other lifelong medical conditions.
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Affiliation(s)
- Lenore Manderson
- School of Public Health, University of the Witwatersrand , Parktown, Johannesburg, South Africa
| | - Ayo Wahlberg
- Department of Anthropology, University of Copenhagen , Copenhagen, Denmark
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Gao D, Zou Z, Zhang W, Chen T, Cui W, Ma Y. Age-Period-Cohort Analysis of HIV Mortality in China: Data from the Global Burden of Disease Study 2016. Sci Rep 2020; 10:7065. [PMID: 32341364 PMCID: PMC7184615 DOI: 10.1038/s41598-020-63141-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 03/23/2020] [Indexed: 01/24/2023] Open
Abstract
The aim of this study was to investigate the long-term trends of human immunodeficiency virus (HIV) mortality in China and its associations with age, period and birth cohort. We used HIV mortality data obtained from the Global Burden of Disease Study (GBD) 2016 and analysed the data with an age-period-cohort framework. Age effects indicate different risks of different outcomes at specific periods in life; period effects reflect population- wide exposure at a circumscribed point in time; and cohort effects generally reflect differences in risk across birth cohorts.Our results showed that the overall annual percentage change (net drift) of HIV mortality was 11.3% (95% CI: 11.0% to 11.6%) for males and 7.2% (95% CI: 7.0% to 7.5%) for females, and the annual percentage changes in each age group (local drift) were greater than 5% (p < 0.01 for all) in both sexes. In the same birth cohort, the risk of death from HIV increased with age in both sexes after controlling for period effects, and the risk for each five-year period was 1.98 for males and 1.57 for females compared to their previous life stage. Compared to the period of 2002–2006, the relative risk (RR) of HIV mortality in 2012–2016 increased by 56.1% in males and 3.7% in females, and compared to the 1955–1959 birth cohort, the cohort RRs increased markedly, by 82.9 times in males and 34.8 times in females. Considering the rapidly increasing risk of HIV mortality, Chinese policymakers should take immediate measures to target the key age group of 15–44 years in both sexes.
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Affiliation(s)
- Disi Gao
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Zhiyong Zou
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Wenjing Zhang
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Tianqi Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Wenxin Cui
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yinghua Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China.
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Secular trends in HIV/AIDS mortality in China from 1990 to 2016: Gender disparities. PLoS One 2019; 14:e0219689. [PMID: 31318900 PMCID: PMC6638923 DOI: 10.1371/journal.pone.0219689] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 06/29/2019] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES HIV/AIDS has become the leading cause of death by infectious disease in China since 2009. However, the trend of gender disparities in HIV/AIDS has not been reported in China since 1990. Our study aimed to explore the secular trend of HIV/AIDS mortality in China from 1990 to 2016 and to identify its gender disparities over the past 27 years. METHOD The mortality data of HIV/AIDS were obtained from the Global Burden of Disease Study 2016 (GBD 2016). Logistic regression was used to estimate the prevalence odds ratio (POR) of gender for HIV/AIDS mortality in different surveys. RESULTS The standardized mortality of HIV/AIDS in China rose dramatically from 0.33 per 100,000 people in 1990 to 2.50 per 100,000 people in 2016. The rate of HIV/AIDS mortality increased more quickly in men than in women, and the sex gap of mortality of HIV/AIDS widened. By 2016, the HIV/AIDS mortality in men was 3 times that in women and was 5.74 times that in women within the 75- to 79-year-old age group. CONCLUSIONS The mortality of HIV/AIDS in China is increasing, with a widening gender disparity. It is critical for policymakers to develop policies to eliminate these disparities and to ensure that everyone can live a long life in full health.
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