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Rapaport SF, Peer AD, Viswasam N, Hahn E, Ryan S, Turpin G, Lyons CE, Baral S, Hansoti B. Implementing HIV Prevention in Sub-Saharan Africa: A Systematic Review of Interventions Targeting Systems, Communities, and Individuals. AIDS Behav 2023; 27:150-160. [PMID: 35913588 PMCID: PMC9851926 DOI: 10.1007/s10461-022-03751-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 01/29/2023]
Abstract
HIV remains a threat to global public health, disproportionately affecting countries across Sub-Saharan Africa. Although treatment and access to care have improved, prevention remains critical to ending new HIV infections by 2030. A variety of prevention strategies exist, yet their effectiveness is difficult to measure and variable due to the nature of the interventions and vulnerability of the intervention during implementation. This systematic review of 51 studies synthesizes data on the implementation and evaluation of evidence-based HIV prevention interventions across Sub-Saharan Africa. Studies were included if they occurred between January 1, 2008, and December 31, 2019, inclusive in Sub-Saharan Africa, were written in English, implemented an HIV prevention intervention in the field, and had reportable results. Using a modified social-ecological model for HIV prevention, we divided studies into three categories: interventions targeting health systems (n = 16), communities (n = 8), and individuals (n = 27). Across all categories, the data emphasized preventing mother-to-child transmission (PMTCT), medical interventions, and psychosocial interventions. The most successful programs bundled several interventions that were integrated into the health system. There is a notable lack of interventions targeting key populations and there are significant rates of loss to follow up (LTFU) across many studies. This review provides insight into the prioritization of evidence-based HIV prevention interventions across Sub-Saharan Africa.
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Affiliation(s)
- Sarah F. Rapaport
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Austin D. Peer
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Nikita Viswasam
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Elizabeth Hahn
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sophia Ryan
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Gnilane Turpin
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Carrie E. Lyons
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Stefan Baral
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Bhakti Hansoti
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,Department of International Health, Bloomberg School of Public Health, Baltimore, Maryland, USA
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Costenbader E, Mangone E, Mueller M, Parker C, MacQueen KM. Rapid organizational network analysis to assess coordination of services for HIV testing clients: an exploratory study. JOURNAL OF HIV/AIDS & SOCIAL SERVICES 2018; 17:16-31. [PMID: 30123100 PMCID: PMC6095663 DOI: 10.1080/15381501.2017.1384779] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Recognizing that HIV testing provides a gateway opportunity to connect with at-risk populations, we explored an approach to collect, analyze and present data on the network of connections between HIV testing organizations and other health and social service agencies operating in Durham County, NC. We surveyed 26 health and social service organizations, including 6 providing HIV testing services, and presented the results including frequency tabulations, network visualizations and metrics, and GIS maps to the participating organizations. Mapping the landscape of organizational relationships was seen as a practical and expedient approach to facilitating cross-sector collaborative efforts to improve community health.
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Affiliation(s)
| | - Emily Mangone
- Global Health Research, FHI 360, Durham, NC
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill
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Smolak A. White slavery, whorehouse riots, venereal disease, and saving women: historical context of prostitution interventions and harm reduction in New York City during the Progressive Era. SOCIAL WORK IN PUBLIC HEALTH 2013; 28:496-508. [PMID: 23805804 PMCID: PMC3703872 DOI: 10.1080/19371918.2011.592083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Harm reduction and structural approaches to reduce HIV risk among sex workers face several barriers. One such barrier is based on moral arguments, and it has a rich historical context. This article examines the historical context of interventions with sex workers in New York City during the Progressive Era (1890-1920). Present at the time, though under a different name, the harm reduction approach was largely dismissed. These same moral underpinnings may be active today in driving interventions and policy toward those that are morally focused and away from those that focus on harm reduction and structural change.
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Affiliation(s)
- Alex Smolak
- Columbia University School of Social Work, New York, NY 10027, USA.
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Keefe RH. Health disparities: a primer for public health social workers. SOCIAL WORK IN PUBLIC HEALTH 2010; 25:237-257. [PMID: 20446173 DOI: 10.1080/19371910903240589] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In 2001, the U.S. Department of Health and Human Services published Healthy People 2010, which identified objectives to guide health promotion and to eliminate health disparities. Since 2001, much research has been published documenting racial and ethnic disparities in healthcare. Although progress has been made in eliminating the disparities, ongoing work by public health social workers, researchers, and policy analysts is needed. This paper focuses on racial and ethnic health disparities, why they exist, where they can be found, and some of the key health/medical conditions identified by the U.S. Department of Health and Human Services to receive attention. Finally, there is a discussion of what policy, professional and community education, and research can to do to eliminate racial and ethnic disparities in healthcare.
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Affiliation(s)
- Robert H Keefe
- School of Social Work, University at Buffalo, State University of New York, Buffalo, New York 14260-1050, USA.
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