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Mwangi L, Mutengu L, Gitau E, Bates I, Pulford J. Strengthening capacity for community and public engagement (CPE): a mixed-methods evaluation of the ‘DELTAS Africa CPE seed fund’ pilot. Wellcome Open Res 2022; 7:96. [PMID: 36051894 PMCID: PMC9386295 DOI: 10.12688/wellcomeopenres.17665.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2022] [Indexed: 11/22/2022] Open
Abstract
Background: The ‘DELTAS Africa CPE seed fund’ was a pilot scheme designed to strengthen capacity in community and public engagement (CPE) via a ‘learn by doing’ approach. The scheme supported a total of 25 early career researchers and research support staff belonging to the DELTAS Africa network to design and implement a variety of CPE projects between August 2019 and February 2021. We examine recipient experiences of the DELTAS Africa CPE seed fund initiative, changes in their CPE attitudes, knowledge and proficiency and their CPE practice and/or practice intentions post-award. Methods: A mixed-methods process and performance evaluation drawing on three data sources: An anonymous, online knowledge, attitude and practice survey completed by CPE seed fund awardees pre- and post-project implementation (N=23); semi-structured interviews completed with a sub-sample of awardees and programme implementors (N=9); and ‘end-of-project’ reports completed by all seed fund awardees (N=25). Results: All awardees described their seed fund experience in positive terms, despite invariably finding it more challenging than originally anticipated. The combined survey, interview and end of project report data all uniformly revealed improvement in awardees’ self-reported CPE knowledge, attitudes and proficiency by completion of their respective projects. Commitment to continued CPE activity post-award was evident in the survey data and all interviewees were adamant that they would integrate CPE within their respective research work going forward. Conclusion: The DELTAS Africa CPE seed fund appeared to work successfully as a CPE capacity strengthening platform and as a vehicle for fostering longer-term interest in CPE activities.
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Affiliation(s)
- Leah Mwangi
- African Population and Health Research Centre, Nairobi, Kenya
| | | | - Evelyn Gitau
- African Population and Health Research Centre, Nairobi, Kenya
| | - Imelda Bates
- Centre for Capacity Research, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Justin Pulford
- Centre for Capacity Research, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
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2
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Haase S, Zweigenthal V, Müller A. Using online spaces to recruit Kenyan queer womxn and trans men in restrictive offline settings. Arch Public Health 2022; 80:82. [PMID: 35287711 PMCID: PMC8919149 DOI: 10.1186/s13690-022-00824-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 02/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Understanding and addressing healthcare and service delivery inequalities is essential to increase equity and overcome health disparities and service access discrimination. While tremendous progress has been made towards the inclusion of sexual and gender minorities in health and other research, gaps still exist. Innovative methods are needed to close these. This case study describes and reflects on using online-based data collection to ascertain sexual health decision-making and health service utilisation among Kenyan queer womxn and trans men. Methods Case study The study used a mixed-methods approach in two phases with triangulated quantitative and qualitative elements. Both elements used web-based technology to gather data. Results Using online spaces to recruit and collect data from queer womxn and trans men exceeded expectations. A total of 360 queer womxn and trans men responded to the digitally distributed survey, and 33 people, queer womxn and trans men, as well as key informants, participated in the interviews, which were primarily conducted on Zoom and Skype. The case study analyses the risks and benefits of this approach and concludes that online sampling approaches can mitigate risks and enable effective and safe sampling of a marginalised group in a restrictive legal setting: Kenyan queer womxn and trans men. Conclusion Using online spaces when researching marginalised populations could effectively overcome risks around stigma, discrimination and violence. It could be an effective way to understand these populations’ healthcare needs better. Factors contributing to success included building trusting relationships with key members of the community, strategic and opportune timing, a nuanced understanding of the mobile landscape, and carefully chosen safety and security measures. However, it should be noted that conducting research online could increase the risk of further marginalising and excluding those without access to web-based technology.
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Affiliation(s)
- Stephanie Haase
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
| | - Virginia Zweigenthal
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Alex Müller
- Department of Medical Ethics and History of Medicine, Universitätsmedizin Göttingen, Göttingen, Germany.,Gender Health and Justice Research Unit, University of Cape Town, Cape Town, South Africa
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Hartmann M, Minnis AM, Krogstad E, Ndwayana S, Sindelo S, Atujuna M, O'Rourke S, Bekker LG, Montgomery ET. iPrevent: Engaging youth as long-acting HIV prevention product co-researchers in Cape Town, South Africa. AFRICAN JOURNAL OF AIDS RESEARCH : AJAR 2021; 20:277-286. [PMID: 34905456 DOI: 10.2989/16085906.2021.1998784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
South African youth are one of the highest risk groups, globally, for HIV acquisition. Identifying prevention methods that will be acceptable and used consistently is an urgent priority. Engaging youth as co-designers is a targeted strategy to achieve the goal of developing prevention products that meet youth's needs. The iPrevent study engaged male and female youth, aged 18-24 years, in Cape Town, South Africa, to co-design critical aspects of the research project aimed at understanding youth preferences for long-acting pre-exposure prophylaxis (PrEP). An established advisory board of young men who have sex with men, women who have sex with men and men-who-have-sex-with-men, as well as a purposively selected youth cohort were involved in film-making, survey design and interpretation of study results. Convening youth as co-designers had several impacts on iPrevent's approach and outputs. Youth input informed the use of local actors in the study's educational video, creating a "real-world" community setting that meaningfully situated the content. Their participation led to the successful development of survey language and images to explain scientific concepts in terms that would resonate (e.g. chili peppers to express product-associated pain). Lastly, their insight reviewing results led to clarifications around misinterpretations of risk perception and confirmed youth's desires for products that fit into their goals around family, future happiness and education. The engagement of youth through creative, interactive activities contributed to adaptations of the study design, research implementation and understanding of results. This was important for connecting with young end-users and translating study findings for product developers in a way that reflected the context of their lives.
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Affiliation(s)
- Miriam Hartmann
- Women's Global Health Imperative, Research Triangle Initiative (RTI) International, San Francisco, USA
| | - Alexandra M Minnis
- Women's Global Health Imperative, Research Triangle Initiative (RTI) International, San Francisco, USA
| | - Emily Krogstad
- Women's Global Health Imperative, Research Triangle Initiative (RTI) International, San Francisco, USA.,The Desmond Tutu HIV Centre, University of Cape Town, South Africa
| | - Sheily Ndwayana
- The Desmond Tutu HIV Centre, University of Cape Town, South Africa
| | | | | | - Shannon O'Rourke
- Women's Global Health Imperative, Research Triangle Initiative (RTI) International, San Francisco, USA
| | | | - Elizabeth T Montgomery
- Women's Global Health Imperative, Research Triangle Initiative (RTI) International, San Francisco, USA
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Abstract
PURPOSE OF REVIEW HIV prevention and treatment interventions for MSM are not well studied or reported from low-income and middle-income countries (LMIC) in comparison to those targeting gender-conforming populations. Some evidence-based strategies to engage MSM in appropriate healthcare have recently reported on their experiences and impact. Novel recruitment strategies have been developed for treatment and preexposure prophylaxis (PrEP) for MSM, leveraging new community engagement strategies and social media technologies. RECENT FINDINGS Despite publication of several new guidelines, there is little recent evidence available to guide MSM health programs in LMIC, highlighting the need for ongoing research and publication. Some important PrEP pilot study results have recently been published, such as the PrEP Brazil and Princess PrEP programmes, which could guide the scale-up of MSM PrEP. The novel use of technology and online platforms to strengthen MSM health delivery and support is particularly important. SUMMARY Providing healthcare to MSM requires consideration of context, broad stakeholder engagement, implementation of best practice guidelines and ongoing situational assessment and integration of novel community engagement methods that are evidence-based. Implementation of improved antiretroviral programmes and the access to PrEP for MSM are vital.
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5
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Sariola S. Intersectionality and Community Engagement: Can Solidarity Alone Solve Power Differences in Global Health Research? THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2020; 20:57-59. [PMID: 32677868 DOI: 10.1080/15265161.2020.1745951] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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6
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Zhao Y, Day S, Yang NS, Bao H, Li L, Mathews A, Tucker JD. Crowdsourcing contests to facilitate community engagement in HIV cure research: a qualitative evaluation of facilitators and barriers of participation. BMC Public Health 2020; 20:67. [PMID: 31941478 PMCID: PMC6964113 DOI: 10.1186/s12889-020-8185-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 01/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As HIV cure research advances, there is an increasing need for community engagement in health research, especially in low- and middle-income countries with ongoing clinical trials. Crowdsourcing contests provide an innovative bottom-up way to solicit community feedback on clinical trials in order to enhance community engagement. The objective of this study was to identify facilitators and barriers to participating in crowdsourcing contests about HIV cure research in a city with ongoing HIV cure clinical trials. METHODS We conducted in-depth interviews to evaluate facilitators and barriers to participating in crowdsourcing contests in Guangzhou, China. Contests included the following activities: organizing a call for entries, promoting the call, evaluating entries, celebrating exceptional entries, and sharing entries. We interviewed 31 individuals, including nine HIV cure clinical trial participants, 17 contest participants, and five contest organizers. Our sample included men who have sex with men (20), people living with HIV (14), and people who inject drugs (5). We audio-recorded, transcribed, and thematically analyzed the data using inductive and deductive coding techniques. RESULTS Facilitators of crowdsourcing contest participation included responsiveness to lived experiences, strong community interest in HIV research, and community trust in medical professionals and related groups. Contests had more participants if they responded to the lived experiences, challenges, and opportunities of living with HIV in China. Strong community interest in HIV research helped to drive the formulation and execution of HIV cure contests, building support and momentum for these activities. Finally, participant trust in medical professionals and related groups (community-based organizations and contest organizers) further strengthened the ties between community members and researchers. Barriers to participating in crowdsourcing contests included persistent HIV stigma and myths about HIV. Stigma associated with discussing HIV made promotion difficult in certain contexts (e.g., city squares and schools). Myths and misperceptions about HIV science confused participants. CONCLUSIONS Our data identified facilitators and barriers of participation in HIV cure crowdsourcing contests in China. Our findings could complement existing HIV community engagement strategies and help to design HIV contests for community engagement in other settings, particularly in low- and middle-income countries.
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Affiliation(s)
- Yang Zhao
- University of North Carolina at Chapel Hill - Project China, No.2 Lujing Road, Guangzhou, China
- School of Social Science, University of Queensland, Brisbane, Australia
| | - Suzanne Day
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Nancy S. Yang
- University of North Carolina at Chapel Hill - Project China, No.2 Lujing Road, Guangzhou, China
- University of Minnesota Medical School - Twin Cities, Minneapolis, USA
| | - Huanyu Bao
- University of North Carolina at Chapel Hill - Project China, No.2 Lujing Road, Guangzhou, China
| | - Linghua Li
- Infectious Diseases Department, Guangzhou Eighth People’s Hospital, Guangzhou, China
| | - Allison Mathews
- University of Minnesota Medical School - Twin Cities, Minneapolis, USA
| | - Joseph D. Tucker
- University of North Carolina at Chapel Hill - Project China, No.2 Lujing Road, Guangzhou, China
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, USA
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Faculty of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
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Coulaud PJ, Préau M, Maradan G, Mora M, Traoré F, Oga M, Thio E, Ekon L, Dembele Keita B, Anoma C, Ter Tiero Dah E, Mensah E, Bernier A, Couderc C, Laurent C, Spire B. Taking empowerment into account: the response of community-based organisations to the HIV care needs of men who have sex with men in West Africa (CohMSM ANRS 12324 - Expertise France). AIDS Care 2019; 31:1403-1411. [PMID: 30829534 DOI: 10.1080/09540121.2019.1587358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Empowerment is an ongoing process through which individuals and communities appropriate power and acquire the capability to function autonomously. Research on empowerment in men who have sex with men (MSM) is lacking in community-based contexts. We investigated the relationship between willingness to be empowered and HIV care needs in West African MSM accessing community-based organisations' (CBO) services. Fifty-three interviews were administered to HIV-negative MSM participating in the CohMSM study (Mali, Burkina Faso, Côte d'Ivoire, Togo). Five indicators of empowerment were identified from a discourse analysis: (i) motivation to access HIV services, (ii) willingness to improve HIV services, (iii) desire to be involved in new activities, (iv) desire to participate in such services, (v) willingness to collaborate in decision making. Based on these indicators, participants were classified into two profiles: high (19/53, 36%) and low (34/53, 64%) level of willingness to be empowered (HWE, LWE). Using a thematic analysis, HWE participants were focused on collective benefit (preventive follow-up, questions about MSM identity), while LWE participants were centred on individual benefit (medical care). CBOs should consider empowerment as a tool to advance collective health benefits for MSM. To improve empowerment in MSM, specific training on issues regarding sexual identity and stigma is needed for CBO providers.
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Affiliation(s)
- Pierre-Julien Coulaud
- INSERM, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Univ , Marseille , France.,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur , Marseille , France
| | - Marie Préau
- INSERM, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Univ , Marseille , France.,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur , Marseille , France.,GRePS Lyon 2 Université, Université de Lyon , Bron , France
| | - Gwenaelle Maradan
- INSERM, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Univ , Marseille , France.,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur , Marseille , France
| | - Marion Mora
- INSERM, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Univ , Marseille , France.,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur , Marseille , France
| | | | - Maxime Oga
- Programme PAC-CI Site ANRS , Abidjan , Côte d'Ivoire
| | - Elisabeth Thio
- Association African Solidarité , Ouagadougou , Burkina Faso
| | | | | | | | - Elias Ter Tiero Dah
- Association African Solidarité , Ouagadougou , Burkina Faso.,Centre Muraz , Bobo-Dioulasso , Burkina Faso
| | | | | | - Clotilde Couderc
- IRD, INSERM, Univ Montpellier, TransVIHMI , Montpellier , France
| | | | - Bruno Spire
- INSERM, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Univ , Marseille , France.,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur , Marseille , France
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8
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Slack C, Wilkinson A, Salzwedel J, Ndebele P. Strengthening stakeholder engagement through ethics review in biomedical HIV prevention trials: opportunities and complexities. J Int AIDS Soc 2018; 21 Suppl 7:e25172. [PMID: 30334604 PMCID: PMC6193317 DOI: 10.1002/jia2.25172] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 07/20/2018] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Clinical trials of biomedical HIV prevention modalities require the cooperation of multiple stakeholders. Key stakeholders, such as community members, may have stark vulnerabilities. Consequently, calls for HIV prevention researchers to implement "stakeholder engagement" are increasingly common. Such engagement is held to benefit inter-stakeholder relations, stakeholders themselves and the research itself. The ethics review process presents a unique opportunity to strengthen stakeholder engagement practices in HIV prevention trials. However, this is not necessarily straightforward. In this article, we consider several complexities. First, is stakeholder engagement a legitimate component of what Research Ethics Committees (RECs) should review for HIV prevention trials? Second, what are the core features of engagement that should be under ethics review? Third, what are the key practices that should be highlighted in ethics review? METHODS To address these questions, we examined the international ethics guidelines specialized for such trials (UNAIDS 2012, UNAIDS-AVAC GPP 2011) and directly applicable to such trials (CIOMS 2016; WHO 2011). Thematic analysis was used to code and analyse these guidelines. RESULTS AND DISCUSSION Ethics guidelines support REC review of engagement. Guidance recommends that engagement be broad and inclusive; early and sustained; and dynamic and responsive. Broad engagement practices include evaluating the context, planning in writing, and resourcing. RECs should assess engagement as part of a comprehensive review, and recommend revisions where necessary. Researchers should profile key elements of engagement valued in ethics guidance, when they draft ethics submissions. Importantly, the ethics review process should not undermine the 'dynamic responsiveness' required for excellent engagement in this field. CONCLUSIONS As evidence-informed engagement strategies emerge, these should inform the ethics submission and review process. Both parties in the review process should strive to avoid a superficial, check-list type approach that caricatures what should be a thorough, nuanced ethics review of a rich, responsive engagement process.
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Affiliation(s)
- Catherine Slack
- HIV AIDS Vaccines Ethics Group (HAVEG)School of Applied Human SciencesCollege of HumanitiesUniversity of KwaZulu‐NatalKwaZulu‐NatalSouth Africa
| | - Abigail Wilkinson
- HIV AIDS Vaccines Ethics Group (HAVEG)School of Applied Human SciencesCollege of HumanitiesUniversity of KwaZulu‐NatalKwaZulu‐NatalSouth Africa
| | | | - Paul Ndebele
- Medical Research Council of Zimbabwe (MRCZ)Causeway, HarareZimbabwe
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9
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Yah CS. Nurturing the Continuum of HIV Testing, Treatment and Prevention Matrix Cascade in Reducing HIV Transmission. Ethiop J Health Sci 2018; 27:621-630. [PMID: 29487471 PMCID: PMC5811941 DOI: 10.4314/ejhs.v27i6.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background Despite the shift in antiretroviral therapy (ARVs) eligibility cascade from CD4 ≤ 200 to CD4 ≤ 350 to CD4 ≤ 500 mm3, HIV related morbidity and mortality continue to escalate annually, as do HIV infections. The new paradigm of treatment for all HIV positives individual irrespective of CD4 count may significantly reduce HIV and related illnesses. The author assumes that all HIV infected partners should be eligible for HIV treatment and care, irrespective of CD4 count. A second assumption is that high risk HIV negative partners have free access to continuum of HIV pre-exposure prophylaxis (PrEP), post exposure prophylaxis (PEP) and other prevention packages. Methods A literature review search was used to extract evidence-based ARVs-HIV treatment and prevention interventions among HIV positives and high risk partners respectively. Only articles published in English and indexed in journal nuclei were used for the study. The information was used to nurture understanding of HIV treatment and prevention approaches as well as HIV incidence multiplier effect among HIV serodiscordant partners. The imputed HIV incident reference was assumed at 1.2 per 100 person-years (2). This was based on the imputation that retention in care, adherence and other predetermined factors are functions of an effective health care delivery system. Result The model showed a reduced HIV transmission from 1.2 per 100 person-years to 1.032 per 100 person-years in 6 months. The average threshold period of HIV suppressed partners on ARVs to an undetectable level. The combined multiplier protective-effect probability of transmitting HIV from HIV positive partners on ARVs-suppressed viremic load to HIV negative partners on PrEP/PEP-prevention was detected at 86% Conclusion The model showed a significant reduction in HIV incidence. Placing serodiscordant sexual partners in HIV treatment and prevention plays a significant role in reducing and controlling HIV infection. Therefore, the policy of enrolling all HIV positives irrespective of CD4 count on ARVs and high risk partners on prevention if adopted and sustained may underpin reduction and control of HIV genotype and HIV related morbidity, mortality and opportunistic infections.
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Affiliation(s)
- Clarence S Yah
- Implementation Science Unit, Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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10
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Gichuru E, Kombo B, Mumba N, Sariola S, Sanders EJ, van der Elst EM. Engaging religious leaders to support HIV prevention and care for gays, bisexual men, and other men who have sex with men in coastal Kenya. CRITICAL PUBLIC HEALTH 2018; 28:294-305. [PMID: 29770367 PMCID: PMC5935049 DOI: 10.1080/09581596.2018.1447647] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 02/28/2018] [Indexed: 01/18/2023]
Abstract
In Kenyan communities, religious leaders are important gatekeepers in matters of health and public morality. In a context that is generally homophobic, religious leaders may aggravate or reduce stigmatization of sexual minorities such as gay and bisexual men, and other men who have sex with men (GBMSM). Literature indicates mixed results in efforts to encourage religious leaders to work effectively and sensitively with issues regarding HIV and sexuality. This paper describes the implementation of an engagement intervention with religious leaders from different denominations, which took place following a homophobic hate attack that was led by local religious leaders, at an HIV research clinic for GBMSM on the Kenyan coast. After the homophobic attack, tailored engagement activities, including a comprehensive four-day online sensitivity training course took place between June 2015 and October 2016 in the Kenyan coast. HIV researchers, together with trained GBMSM activists, organized the series of engagement activities for religious leaders which unfolded iteratively, with each subsequent activity informed by the results of the previous one. Facilitated conversations were used to explore differences and disagreements in relation to questions of scripture, mission, HIV, and human sexuality. As a result, researchers noted that many religious leaders, who initially expressed exceedingly negative attitudes towards GBMSM, started to express far more accepting and supportive views of sexuality, sexual identities, and same-sex relations. This paper describes the changes in religious leaders’ discourses relating to GBMSM, and highlights the possibility of using engagement interventions to build trust between research institutes, religious leaders, and GBMSM.
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Affiliation(s)
- Evans Gichuru
- Kenya Medical Research Institute - Wellcome Trust Research Programme, Kilifi, Kenya
| | - Bernadette Kombo
- Kenya Medical Research Institute - Wellcome Trust Research Programme, Kilifi, Kenya
| | - Noni Mumba
- Kenya Medical Research Institute - Wellcome Trust Research Programme, Kilifi, Kenya
| | - Salla Sariola
- Nuffield Department of Population Health, University of Oxford, Oxford, UK.,University of Turku, Turku, Finland
| | - Eduard J Sanders
- Kenya Medical Research Institute - Wellcome Trust Research Programme, Kilifi, Kenya.,Department of Global Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.,Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Elise M van der Elst
- Kenya Medical Research Institute - Wellcome Trust Research Programme, Kilifi, Kenya.,Department of Global Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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11
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Reynolds L, Sariola S. The ethics and politics of community engagement in global health research. CRITICAL PUBLIC HEALTH 2018. [DOI: 10.1080/09581596.2018.1449598] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Lindsey Reynolds
- Population Studies and Training Centre, Brown University, USA
- Department of Sociology and Social Anthropology, Stellenbosch University, South Africa
| | - Salla Sariola
- Department of Sociology, University of Turku, Finland
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12
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Hassan NR, Swartz L, Kagee A, De Wet A, Lesch A, Kafaar Z, Newman PA. "There is not a safe space where they can find themselves to be free": (Un)safe spaces and the promotion of queer visibilities among township males who have sex with males (MSM) in Cape Town, South Africa. Health Place 2017; 49:93-100. [PMID: 29227887 DOI: 10.1016/j.healthplace.2017.11.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 11/30/2017] [Accepted: 11/30/2017] [Indexed: 11/28/2022]
Abstract
Males who have sex with males (MSM) are prioritised in the global fight against HIV/AIDS, as a key affected population to receive HIV prevention, treatment, and HIV-related care and support (WHO, 2016). There is, however, limited empirical research conducted on how to engage communities of South African MSM in clinical HIV prevention research programs. The development of LGBTIQ safe spaces may potentially be a viable option to promote community-based engagement by bridging the divides between HIV-prevention researchers, marginalised queer populations, and other HIV-prevention stakeholders located in heteronormative spaces (Molyneux et al., 2016). We conducted ten in-depth, qualitative interviews with MSM safe space members who have been involved in HIV prevention research programs. Data were analysed using a thematic analytic strategy (Braun and Clarke, 2006). Our results indicate that the "safe spaces" currently operational in Cape Town are not stable spaces nor are they always safe, but they form part of a broader and much more long-term political and geographical strategy of inclusion and emancipation.
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Affiliation(s)
- N R Hassan
- Department of Psychology, Stellenbosch University, Private Bag ×1, Matieland 7602, South Africa.
| | - L Swartz
- Department of Psychology, Stellenbosch University, Private Bag ×1, Matieland 7602, South Africa.
| | - A Kagee
- Department of Psychology, Stellenbosch University, Private Bag ×1, Matieland 7602, South Africa.
| | - A De Wet
- Department of Psychology, Stellenbosch University, Private Bag ×1, Matieland 7602, South Africa.
| | - A Lesch
- Department of Psychology, Stellenbosch University, Private Bag ×1, Matieland 7602, South Africa.
| | - Z Kafaar
- Department of Psychology, Stellenbosch University, Private Bag ×1, Matieland 7602, South Africa.
| | - P A Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario, Canada M5S 1V4.
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13
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Kombo B, Sariola S, Gichuru E, Molyneux S, Sanders EJ, van der Elst E. " Facing Our Fears": Using facilitated film viewings to engage communities in HIV research involving MSM in Kenya. COGENT MEDICINE 2017; 4:1330728. [PMID: 28670602 PMCID: PMC5470105 DOI: 10.1080/2331205x.2017.1330728] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 05/11/2017] [Indexed: 10/29/2022] Open
Abstract
Kenya is a generally homophobic country where homosexuality is criminalised and people who engage in same sex sexuality face stigma and discrimination. In 2013, we developed a 16 min documentary entitled "Facing Our Fears" that aimed at sharing information on how and why men who have sex with men (MSM) are involved in on-going KEMRI HIV prevention research, and associated community engagement. To consider the film's usefulness as a communication tool, and its perceived security risks in case the film was publicly released, we conducted nine facilitated viewings with 122 individuals representing seven different stakeholder groups. The documentary was seen as a strong visual communication tool with potential to reduce stigma related to homosexuality, and facilitated film viewings were identified as platforms with potential to support open dialogue about HIV research involving MSM. Despite the potential, there were concerns over possible risks to LGBT communities and those working with them following public release. We opted-giving emphasis to the "do no harm" principle-to use the film only in facilitated settings where audience knowledge and attitudes can be carefully considered and discussed. The results highlight the importance of carefully assessing the range of possible impacts when using visuals in community engagement.
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Affiliation(s)
- Bernadette Kombo
- HIV Key Populations Studies, KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya
| | - Salla Sariola
- Department of Public Health, The Ethox Centre, University of Oxford, Oxford, UK.,Faculty of Social Sciences, University of Turku, Turku, Finland
| | - Evanson Gichuru
- HIV Key Populations Studies, KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya
| | - Sassy Molyneux
- Department of Public Health, The Ethox Centre, University of Oxford, Oxford, UK.,Department of Health Systems and Research Ethics, KEMRI/Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya.,Nuffield Department of Medicine, The Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Oxford, UK
| | - Eduard J Sanders
- HIV Key Populations Studies, KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya.,Nuffield Department of Medicine, The Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Oxford, UK.,Department of Global Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Elise van der Elst
- HIV Key Populations Studies, KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya.,Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
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14
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Singh A, Jenkins C, Calys-Tagoe B, Arulogun OS, Sarfo S, Ovbiagele B, Akpalu A, Melikam S, Uvere E, Owolabi MO. Stroke Investigative Research and Education Network: Public Outreach and Engagement. ACTA ACUST UNITED AC 2017; 7. [PMID: 28868210 PMCID: PMC5577935 DOI: 10.4172/2161-0711.1000518] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Stroke is becoming a leading cause of disability and death, and a major public health concern in Sub-Saharan Africa (SSA). The Stroke Investigative Research and Education Network (SIREN) seeks to comprehensively characterize the genomic, sociocultural, economic, and behavioral risk factors for stroke and to build effective teams for research to address and decrease the burden of stroke and other non-communicable diseases in SSA. One of the first steps to address this goal was to effectively engage the communities that suffer high burdens of disease in SSA. This paper describes the process of SIREN project's community engagement activities in Ghana and Nigeria. The aims of community engagement (CE) within SIREN are to: i) elucidate information about knowledge, attitudes, beliefs, and practices (KABP) about stroke and its risk factors from individuals of African ancestry in SSA; ii) educate the community about stroke and ways to decrease disabilities and deaths from stroke; and iii) recruit 3000 control research subjects to participate in a case-control stroke study. CE focused on three-pronged activities-constitution and interaction with Community Advisory Board (CABs), Focus Group Discussions (n=27) and community education and outreach programs (n=88). FGDs and outreach programs indicate that knowledge of stroke, as well as risk factors and follow-up evidence-based care is limited and often late. Almost all indicated that genetic testing could help health provider’s better treat stroke and help scientists better understand the causes of stroke. Over 7000 individuals have received education on cardiovascular risk factors and about 5,000 have been screened for cardiovascular risk factors during the outreaches. The CE core within SIREN is a first of its kind public outreach engagement initiative to evaluate and address perceptions about stroke and genomics by patients, caregivers, and local leaders in SSA and has implications as a model for assessment in other high stroke risk populations.
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Affiliation(s)
- A Singh
- Department of Public Health, KNUST Hospital, Kumasi, Ghana
| | - C Jenkins
- Department of Public Health, KNUST Hospital, Kumasi, Ghana
| | - B Calys-Tagoe
- Department of Public Health, KNUST Hospital, Kumasi, Ghana
| | - O S Arulogun
- Department of Public Health, KNUST Hospital, Kumasi, Ghana
| | - S Sarfo
- Department of Public Health, KNUST Hospital, Kumasi, Ghana
| | - B Ovbiagele
- Department of Public Health, KNUST Hospital, Kumasi, Ghana
| | - A Akpalu
- Department of Public Health, KNUST Hospital, Kumasi, Ghana
| | - S Melikam
- Department of Public Health, KNUST Hospital, Kumasi, Ghana
| | - E Uvere
- Department of Public Health, KNUST Hospital, Kumasi, Ghana
| | - M O Owolabi
- Department of Public Health, KNUST Hospital, Kumasi, Ghana
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15
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Yah CS, Tambo E, Khayeka-Wandabwa C, Ngogang JY. Impact of telemonitoring approaches on integrated HIV and TB diagnosis and treatment interventions in sub-Saharan Africa: a scoping review. Health Promot Perspect 2017; 7:60-65. [PMID: 28326285 PMCID: PMC5350551 DOI: 10.15171/hpp.2017.12] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 01/22/2017] [Indexed: 11/09/2022] Open
Abstract
Background: This paper explores telemonitoring/mhealth approaches as a promising real time and contextual strategy in overhauling HIV and TB interventions quality access and uptake, retention,adherence and coverage impact in endemic and prone-epidemic prevention and control in sub-Sahara Africa. Methods: The scoping review method was applied in acknowledged journals indexing platforms including Medline, Embase, Global Health, PubMed, MeSH PsycInfo, Scopus and Google Scholar to identify relevant articles pertaining to telemonitoring as a proxy surrogate method in reinforcing sustainability of HIV/TB prevention/treatment interventions in sub-Saharan Africa. Full papers were assessed and those selected that fosters evidence on telemonitoring/mhealth diagnosis, treatment approaches and strategies in HIV and TB prevention and control were synthesized and analyzed. Results: We found telemonitoring/mhealth approach as a more efficient and sustained proxy in HIV and TB risk reduction strategies for early diagnosis and prompt quality clinical outcomes. It can significantly contribute to decreasing health systems/patients cost, long waiting time in clinics, hospital visits, travels and time off/on from work. Improved integrated HIV and TB telemonitoring systems sustainability hold great promise in health systems strengthening including patient centered early diagnosis and care delivery systems, uptake and retention to medications/services and improving patients' survival and quality of life. Conclusion: Telemonitoring/mhealth (electronic phone text/video/materials messaging)acceptability, access and uptake are crucial in monitoring and improving uptake, retention,adherence and coverage in both local and national integrated HIV and TB programs and interventions. Moreover, telemonitoring is crucial in patient-providers-health professional partnership, real-time quality care and service delivery, antiretroviral and anti-tuberculous drugs improvement, susceptibility monitoring and prescription choice, reinforcing cost effective HIV and TB integrated therapy model and survival rate.
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Affiliation(s)
- Clarence S Yah
- WITS Reproductive & HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Biochemistry & Microbiology, Nelson Mandela Metropolitan University, South Africa
| | - Ernest Tambo
- Department Biochemistry and Pharmaceutical Sciences, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon; Africa Disease Intelligence and Surveillance, Communication and Response (Africa DISCoR) Institute, Yaoundé, Cameroon
| | | | - Jeanne Y Ngogang
- Department Biochemistry and Pharmaceutical Sciences, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon
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