1
|
Hofmeyr GJ, Singata-Madliki M, Batting J, Steyn P, Thomas KK, Issema R, Beesham I, Mbatsane E, Morrison C, Deese J, Smit J, Philip N, Palanee-Phillips T, Reddy K, Onono M, Mastro TD, Baeten JM. Sexual behaviour among women using intramuscular depot medroxyprogesterone acetate, a copper intrauterine device, or a levonorgestrel implant for contraception: Data from the ECHO randomized trial. PLoS One 2024; 19:e0299802. [PMID: 38722832 PMCID: PMC11081305 DOI: 10.1371/journal.pone.0299802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 01/31/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Contraceptive use has complex effects on sexual behaviour and mood, including those related to reduced concerns about unintended pregnancy, direct hormonal effects and effects on endogenous sex hormones. We set out to obtain robust evidence on the relative effects of three contraceptive methods on sex behaviours, which is important for guiding contraceptive choice and future contraceptive developments. METHODS This is a secondary analysis of data from the Evidence for Contraceptive Options and HIV Outcomes (ECHO) randomized trial in which 7,829 HIV-uninfected women from 12 sites in Eswatini, Kenya, South Africa and Zambia seeking contraception were randomly assigned to intramuscular depot-medroxyprogesterone acetate (DMPA-IM), the copper intrauterine device (Cu-IUD) or the levonorgestrel (LNG) implant. Data collected for 12 to 18 months using 3-monthly behavioural questionnaires that relied on recall from the preceding 3 months, were used to estimate relative risk of post-baseline sex behaviours, as well as sexual desire and menstrual bleeding between randomized groups using modified Poisson regression. RESULTS We observed small but generally consistent effects wherein DMPA-IM users reported lower prevalence of specified high risk sexual behaviours than implant users than Cu-IUD users (the '>' and '<' symbols indicate statistically significant differences): multiple sex partners 3.6% < 4.8% < 6.2% respectively; new sex partner 3.0% < 4.0% <5.3%; coital acts 16.45, 16.65, 17.12 (DMPA-IM < Cu-IUD); unprotected sex 65% < 68%, 70%; unprotected sex past 7 days 33% <36%, 37%; sex during vaginal bleeding 7.1%, 7.1% < 8.9%; no sex acts 4.1%, 3.8%, 3.4% (DMPA-IM > Cu-IUD); partner has sex with others 10% < 11%, 11%. The one exception was having any sex partner 96.5%, 96.9% < 97.4% (DMPA-IM < Cu-IUD). Decrease in sexual desire was reported by 1.6% > 1.1% >0.5%; amenorrhoea by 49% > 41% >12% and regular menstrual pattern by 26% <35% < 87% respectively. CONCLUSIONS These findings suggest that women assigned to DMPA-IM may have a modest decrease in libido and sexual activity relative to the implant, and the implant relative to the Cu-IUD. We found more menstrual disturbance with DMPA-IM than with the implant (and as expected, both more than the Cu-IUD). These findings are important for informing the contraceptive choices of women and policymakers and highlight the need for robust comparison of the effects of other contraceptive methods as well.
Collapse
Affiliation(s)
- G. Justus Hofmeyr
- University of Botswana, Gaborone, Botswana
- Effective Care Research Unit, University of the Witwatersrand/Walter Sisulu University, East London, South Africa
| | - Mandisa Singata-Madliki
- Effective Care Research Unit, University of Witwatersrand, University of Fort Hare, East London, South Africa
| | - Joanne Batting
- Effective Care Research Unit, University of Witwatersrand, University of Fort Hare, East London, South Africa
| | - Petrus Steyn
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Geneva, Switzerland
| | - Katherine K. Thomas
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Rodal Issema
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
| | - Ivana Beesham
- Faculty of Health Sciences, Department of Obstetrics and Gynaecology, MatCH Research Unit (MRU), University of the Witwatersrand, Durban, South Africa
| | | | | | - Jen Deese
- Pfizer Inc., Collegeville, Pennsylvania, United States of America
| | - Jenni Smit
- Faculty of Health Sciences, Department of Obstetrics and Gynaecology, MatCH Research Unit (MRU), University of the Witwatersrand, Durban, South Africa
| | - Neena Philip
- Mailman School of Public Health, ICAP at Columbia University, New York, New York, United States of America
| | - Thesla Palanee-Phillips
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Wits Reproductive Health and HIV Institute, School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Krishnaveni Reddy
- Wits Reproductive Health and HIV Institute, School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Maricianah Onono
- Kenya Medical Research Institute, Centre for Microbiology Research, Kisumu, Kenya
| | | | - Jared M. Baeten
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Gilead Sciences, Foster City, California, United States of America
| | | |
Collapse
|
2
|
Singata-Madliki M, Smit J, Beksinska M, Balakrishna Y, Avenant C, Beesham I, Seocharan I, Batting J, Hapgood JP, Hofmeyr GJ. Effects of injectable contraception with depot medroxyprogesterone acetate or norethisterone enanthate on estradiol levels and menstrual, psychological and behavioral measures relevant to HIV risk: The WHICH randomized trial. PLoS One 2024; 19:e0295764. [PMID: 38530848 DOI: 10.1371/journal.pone.0295764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 11/14/2023] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Observational data suggest lower HIV risk with norethisterone enanthate (NET-EN) than with depo-medroxyprogesterone acetate intramuscular (DMPA-IM) injectable contraceptives. If confirmed, a switch between these similar injectable methods would be programmatically feasible and could impact the trajectory of the HIV epidemic. We aimed in this paper to investigate the effects of DMPA-IM and NET-EN on estradiol levels, measures of depression and sexual activity and menstrual effects, relevant to HIV risk; and to ascertain whether these measures are associated with estradiol levels. METHODS This open-label trial conducted at two sites in South Africa from 5 November 2018 to 30 November 2019, randomized HIV-negative women aged 18-40 to DMPA-IM 150 mg intramuscular 12-weekly (n = 262) or NET-EN 200 mg intramuscular 8-weekly (n = 259). Data were collected on hormonal, behavioral and menstrual effects at baseline and at 25 weeks (25W). RESULTS At 25W, median 17β estradiol levels were substantially lower than at baseline (p<0.001) for both methods: 76.5 pmol/L (interquartile range (IQR) 54.1 to 104.2) in the DMPA-IM group (n = 222), and 69.8 pmol/L (IQR: 55.1 to 89.3) in the NET-EN group (n = 225), with no statistical difference between the two methods (p = 0.450). Compared with DMPA-IM, NET-EN users reported significantly less amenorrhoea, fewer sexual acts, fewer users reporting at least one act of unprotected sex, more condom use with steady partner, more days with urge for sexual intercourse, more days feeling partner does not love her, and more days feeling sad for no reason. We did not find a clear association between estradiol levels and sexual behavior, depression and menstrual effects. Behavioral outcomes suggest less sexual exposure with NET-EN than DMPA-IM. The strength of this evidence is high due to the randomized study design and the consistency of results across the outcomes measured. CONCLUSIONS Estradiol levels were reduced to postmenopausal levels by both methods. Secondary outcomes suggesting less sexual exposure with NET-EN are consistent with reported observational evidence of less HIV risk with NET-EN. A randomized trial powered for HIV acquisition is feasible and needed to answer this important question. TRIAL REGISTRATION PACTR 202009758229976.
Collapse
Affiliation(s)
- Mandisa Singata-Madliki
- Effective Care Research Unit, Eastern Cape Department of Health/Universities of the Witwatersrand and Fort Hare, East London, South Africa
| | - Jenni Smit
- Wits MRU (MatCH Research Unit), Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Mags Beksinska
- Wits MRU (MatCH Research Unit), Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Yusentha Balakrishna
- Biostatistics Research Unit, South African Medical Research Council, Durban, South Africa
| | - Chanel Avenant
- Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa
| | - Ivana Beesham
- Wits MRU (MatCH Research Unit), Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Ishen Seocharan
- Biostatistics Research Unit, South African Medical Research Council, Durban, South Africa
| | - Joanne Batting
- Effective Care Research Unit, Eastern Cape Department of Health/Universities of the Witwatersrand and Fort Hare, East London, South Africa
| | - Janet P Hapgood
- Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - G Justus Hofmeyr
- Effective Care Research Unit, Eastern Cape Department of Health/Universities of the Witwatersrand and Fort Hare, East London, South Africa
- Walter Sisulu University, East London, South Africa
- Department of Obstetrics and Gynecology, University of Botswana, Gabarone, Botswana
| |
Collapse
|
3
|
Avenant C, Bick AJ, Skosana SB, Dlamini S, Balakrishna Y, Moliki JM, Singata-Madliki M, Hofmeyr GJ, Smit J, Beksinska M, Beesham I, Seocharan I, Batting J, Chen PL, Storbeck KH, Africander D, Hapgood JP. Misreporting contraceptive use and the association of peak study progestin levels with weight and BMI among women randomized to the progestin-only injectable contraceptives DMPA-IM and NET-EN. PLoS One 2023; 18:e0295959. [PMID: 38134043 PMCID: PMC10745193 DOI: 10.1371/journal.pone.0295959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/02/2023] [Indexed: 12/24/2023] Open
Abstract
Progestin-only injectable contraceptives, mainly depo-medroxyprogesterone acetate intramuscular (DMPA-IM), are the most widely used contraceptive methods in sub-Saharan Africa. Insufficient robust data on their relative side-effects and serum concentrations limit understanding of reported outcomes in contraception trials. The WHICH clinical trial randomized HIV-negative women to DMPA-IM (n = 262) or norethisterone enanthate (NET-EN) (n = 259) at two South African sites between 2018-2019. We measured serum concentrations of study and non-study progestins at initiation (D0) and peak serum levels, one week after the 24-week injection [25 weeks (25W)], (n = 435) and investigated associations between study progestin levels, and BMI and weight of participants. Peak median serum concentrations were 6.59 (IQR 4.80; 8.70) nM for medroxyprogesterone (MPA) (n = 161) and 13.6 (IQR 9.01; 19.0) nM for norethisterone (NET) (n = 155). MPA was the most commonly quantifiable non-study progestin at D0 in both arms (54%) and at 25W in the NET-EN arm (27%), followed by NET at D0 in both arms (29%) and at 25W in the DMPA-IM arm (19%). Levonorgestrel was quantifiable in both arms [D0 (6.9%); 25W (3.4%)], while other progestins were quantifiable in ≤ 14 participants. Significant negative time-varying associations were detected between MPA and NET concentrations and weight and BMI in both contraceptive arms and a significant increase was detected for peak serum progestin concentrations for normal weight versus obese women. Contraceptive-related reported outcomes are likely confounded by MPA, more so than NET, with reported DMPA-IM effects likely underestimated, at sites where DMPA-IM is widely used, due to misreporting of contraceptive use before and during trials, and 'tail' effects of DMPA-IM use more than six months before trial enrolment. Peak serum levels of MPA and NET are negatively associated with BMI and weight, suggesting another source of variability between trial outcomes and a potential increase in side-effects for normal weight versus overweight and obese women. Trail registration: The clinical trial was registered with the Pan African Clinical Trials Registry (PACTR 202009758229976).
Collapse
Affiliation(s)
- Chanel Avenant
- Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa
| | - Alexis J. Bick
- Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa
| | - Salndave B. Skosana
- Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa
| | - Sigcinile Dlamini
- Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa
| | - Yusentha Balakrishna
- Biostatistics Research Unit, South African Medical Research Council, Durban, South Africa
| | - Johnson Mosoko Moliki
- Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa
| | - Mandisa Singata-Madliki
- Effective Care Research Unit, Eastern Cape Department of Health, Universities of the Witwatersrand and Fort Hare, East London, South Africa
| | - G. Justus Hofmeyr
- Effective Care Research Unit, Eastern Cape Department of Health, Universities of the Witwatersrand and Fort Hare, East London, South Africa
- Walter Sisulu University, East London, South Africa
- Department of Obstetrics and Gynecology, University of Botswana, Gabarone, Botswana
| | - Jenni Smit
- Wits MRU (MatCH Research Unit), Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Mags Beksinska
- Wits MRU (MatCH Research Unit), Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Ivana Beesham
- Wits MRU (MatCH Research Unit), Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Ishen Seocharan
- Biostatistics Research Unit, South African Medical Research Council, Durban, South Africa
| | - Joanne Batting
- Effective Care Research Unit, Eastern Cape Department of Health, Universities of the Witwatersrand and Fort Hare, East London, South Africa
| | - Pai-Lien Chen
- Family Health International (FHI) 360, Durham, North Carolina, United States of America
| | - Karl-Heinz Storbeck
- Department of Biochemistry, Stellenbosch University, Stellenbosch, South Africa
| | - Donita Africander
- Department of Biochemistry, Stellenbosch University, Stellenbosch, South Africa
| | - Janet P. Hapgood
- Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
4
|
Beksinska M, Smit J, Mona A, Maphumulo V, Mphili N, Manzini-Matebula N, Chidarikire T. Female condom color and scent preference in Durban, South Africa. Contracept X 2023; 5:100095. [PMID: 37554547 PMCID: PMC10404533 DOI: 10.1016/j.conx.2023.100095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVES To assess preferences for female condom (FC) colors and scents. STUDY DESIGN Women aged 18-40 years were randomized to one of three FCs (FC2, Cupid1, Cupid2) two of which offered a choice of color and scent (red/strawberry, purple/vanilla, natural/unscented). Women could choose any variety within condom types while participating in an FC contraceptive efficacy study in South Africa. RESULTS One hundred and thirty-three women were allocated to each FC type. Strawberry was the most popular variety for both FC2 and Cupid1 (60.9%, 78.3% respectively). Some women chose more than one variety but few chose the natural. CONCLUSIONS Data support a clear preference for colored and scented FCs. IMPLICATIONS These data can inform FC programme managers to predict demand for different varieties of FC and can adjust supply of FCs accordingly.
Collapse
Affiliation(s)
- Mags Beksinska
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Jenni Smit
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Amanda Mona
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Virginia Maphumulo
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Nonhlanhla Mphili
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | | | | |
Collapse
|
5
|
Beesham I, Milford C, Smit J, Joseph Davey DL, Baeten JM, Heffron R, Beksinska M, Mansoor LE. Post-trial access to and use of pre-exposure prophylaxis in Durban, South Africa. BMC Public Health 2023; 23:1210. [PMID: 37349816 PMCID: PMC10286415 DOI: 10.1186/s12889-023-16139-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 06/16/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND HIV endpoint-driven clinical trials increasingly provide oral pre-exposure prophylaxis (PrEP) as standard of prevention during the trial, however, among participants desiring to continue using PrEP at trial exit, little is known about post-trial PrEP access and continued use. METHODS We conducted one-time, semi-structured, face-to-face, in-depth interviews with 13 women from Durban, South Africa, from November to December 2021. We interviewed women who initiated oral PrEP as part of the HIV prevention package during the Evidence for Contraceptive Options and HIV Outcomes (ECHO) Trial, elected to continue using PrEP at study exit, and were given a 3-month PrEP supply and referred to facilities for PrEP refills at the final trial visit. The interview guide probed for barriers and enablers to post-trial PrEP access, and current and future PrEP use. Interviews were audio-recorded and transcribed. Thematic analysis was facilitated using NVivo. RESULTS Of the 13 women, six accessed oral PrEP post-trial exit, but five later discontinued. The remaining seven women did not access PrEP. Barriers to post-trial PrEP access and continued use included PrEP facilities having long queues, inconvenient operating hours, and being located far from women's homes. Some women were unable to afford transport costs to collect PrEP. Two women reported visiting their local clinics and requesting PrEP but were informed that PrEP was unavailable at the clinic. Only one woman was still using PrEP at the time of the interview. She reported that the PrEP facility was located close to her home, staff were friendly, and PrEP education and counselling were provided. Most women not on PrEP reported wanting to use it again, particularly if barriers to access could be alleviated and PrEP was easily available at facilities. CONCLUSIONS We identified several barriers to post-trial PrEP access. Strategies to enhance PrEP access such as a reduction in waiting queues, convenient facility operating hours, and making PrEP more widely available and accessible are needed. It is also worth noting that oral PrEP access has expanded in South Africa from 2018 till now and this could improve access to PrEP for participants exiting trials who desire to continue PrEP.
Collapse
Affiliation(s)
- Ivana Beesham
- Wits MatCH Research Unit (WMRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Cecilia Milford
- Wits MatCH Research Unit (WMRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Jenni Smit
- Wits MatCH Research Unit (WMRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Dvora L. Joseph Davey
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Division of Infectious Diseases, Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - Jared M. Baeten
- Department of Global Health, Department of Epidemiology, Department of Medicine, University of Washington, Seattle, WA USA
- Gilead Sciences, Foster City, CA USA
| | - Renee Heffron
- University of Alabama at Birmingham, Alabama, USA
- Department of Global Health and Department of Epidemiology, University of Washington, Seattle, WA USA
| | - Mags Beksinska
- Wits MatCH Research Unit (WMRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Leila E. Mansoor
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
6
|
Beesham I, Milford C, Joseph Davey DL, Smit J, Mansoor LE, Beksinska M. Key stakeholders' perspectives on providing oral pre-exposure prophylaxis as HIV-prevention standard of care in clinical trials in South Africa. Afr J AIDS Res 2023; 22:18-26. [PMID: 36951406 DOI: 10.2989/16085906.2023.2169177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
Introduction: HIV-prevention and endpoint-driven clinical trials enrol individuals at substantial risk of HIV. Recently, these trials have provided oral pre-exposure prophylaxis (PrEP) as HIV-prevention standard of care; however, data on PrEP uptake and use during the trial and post-trial access are lacking.Methods: We conducted once-off, telephonic, in-depth interviews from August 2020 to March 2021, with 15 key stakeholders (including site directors/leaders, principal investigators and clinicians), purposively recruited from research sites across South Africa that are known to conduct HIV-prevention and endpoint-driven clinical trials. The interview guide probed for facilitators and barriers to PrEP uptake and use during the trial, and post-trial PrEP access. Interviews were audio recorded and transcribed. Coding was facilitated using NVivo and emergent themes were identified.Results: Most stakeholders reported incorporating PrEP as part of the HIV-prevention package in HIV-prevention and endpoint-driven clinical trials. Stakeholders identified multiple barriers to PrEP uptake and use, including difficulties with daily pill taking, side effects, stigma, a lack of demand creation and limited knowledge and education about PrEP in communities. Facilitators of PrEP uptake and use included demand-creation campaigns and trial staff providing quality counselling and education. Post-trial PrEP access was frequently challenging as facilities were located a considerable distance from research sites, had long queues and inconvenient operating hours.Conclusions: Strategies to address barriers to PrEP uptake and use during trials and post-trial access, such as PrEP demand creation, education and counselling, addressing stigma, support for daily pill-taking and increased post-trial access, are urgently needed.
Collapse
Affiliation(s)
- Ivana Beesham
- Wits MatCH Research Unit, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Cecilia Milford
- Wits MatCH Research Unit, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Dvora L Joseph Davey
- Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa
- Division of Infectious Diseases, Geffen School of Medicine, University of California, Los Angeles, USA
| | - Jenni Smit
- Wits MatCH Research Unit, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Leila E Mansoor
- Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa
| | - Mags Beksinska
- Wits MatCH Research Unit, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| |
Collapse
|
7
|
Beksinska M, Mphili N, Smit J. Functional performance of the Wondaleaf condom: A crossover, noninferiority, randomized clinical trial. Int J STD AIDS 2023; 34:114-121. [PMID: 36426764 DOI: 10.1177/09564624221139899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND New female condom (FC) products wishing to apply for United Nations Population Fund/World Health Organisation (UNFPA/WHO) prequalification are required to conduct a randomized, controlled clinical investigation comparing the new FC to the marketed FC, in order to comply with UNFPA/WHO and International Organization for Standardization (ISO) specifications. We aimed to assess the functional performance, acceptability and safety of the Wondaleaf female condom compared to the control FC2 female condom. METHODS This randomized clinical trial enrolled 220 women in one South African site. The primary outcome of the study was the rate of female condom (FC) failure. Participants were asked to use five of each FC type and to collect information on use in a condom diary at home, and were interviewed after use of each FC type. RESULTS Noninferiority was demonstrated for the Wondaleaf with respect to the reference FC2 for all condom functions. The Wondaleaf was found to be superior to the FC2 reference condom for invagination (p > .000), misdirection (p > .000) and clinical failure (p > .000). Acceptability ratings for a range of features were similar between the two FCs. Few safety events were reported for either device. CONCLUSION The Wondaleaf performs as well as the FC2, and is equally acceptable. Results from this study will inform further refinement of this FC design. Trial registrations: ClinicalTrials.gov Identifier: NCT04076774 https://clinicaltrials.gov/. South African National Clinical Trials Database (SANCTR) number DOH-27-0319-6020.
Collapse
Affiliation(s)
- Mags Beksinska
- Match Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, 37708University of the Witwatersrand, Durban, South Africa
| | - Nonhlanhla Mphili
- Match Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, 37708University of the Witwatersrand, Durban, South Africa
| | - Jenni Smit
- Match Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, 37708University of the Witwatersrand, Durban, South Africa
| |
Collapse
|
8
|
Psaros C, Stanton AM, Raggio GA, Mosery N, Goodman GR, Briggs ES, Williams M, Bangsberg D, Smit J, Safren SA. Optimizing PMTCT Adherence by Treating Depression in Perinatal Women with HIV in South Africa: A Pilot Randomized Controlled Trial. Int J Behav Med 2023; 30:62-76. [PMID: 35260947 PMCID: PMC9452601 DOI: 10.1007/s12529-022-10071-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND South Africa (SA) has the greatest HIV prevalence in the world, with rates as high as 40% among pregnant women. Depression is a robust predictor of nonadherence to antiretroviral therapy (ART) and engagement in HIV care; perinatal depression may affect upwards of 47% of women in SA. Evidence-based, scalable approaches for depression treatment and ART adherence in this setting are lacking. METHOD Twenty-three pregnant women with HIV (WWH), ages 18-45 and receiving ART, were randomized to a psychosocial depression and adherence intervention or treatment as usual (TAU) to evaluate intervention feasibility, acceptability, and preliminary effect on depressive symptoms and ART adherence. Assessments were conducted pre-, immediately post-, and 3 months post-treatment, and included a qualitative exit interview. RESULTS Most (67.6%) eligible individuals enrolled; 71% completed at least 75% of sessions. Compared to TAU, intervention participants had significantly greater improvements in depressive symptoms at post-treatment, β = - 11.1, t(24) = - 3.1, p < 0.005, 95% CI [- 18.41, - 3.83], and 3 months, β = - 13.8, t(24) = - 3.3, p < 0.005, 95% CI [- 22.50, - 5.17]. No significant differences in ART adherence, social support, or stigma were found. Qualitatively, perceived improvements in social support, self-esteem, and problem-solving adherence barriers emerged as key benefits of the intervention; additional sessions were desired. CONCLUSION A combined depression and ART adherence intervention appears feasible and acceptable, and demonstrated preliminary evidence of efficacy in a high-need population. Additional research is needed to confirm efficacy and identify dissemination strategies to optimize the health of WWH and their children. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03069417. Protocol available at https://clinicaltrials.gov/ct2/show/NCT03069417.
Collapse
Affiliation(s)
- Christina Psaros
- Department of Psychiatry, Massachusetts General Hospital / Harvard Medical School, Boston, MA, USA.
- , Boston, USA.
| | - Amelia M Stanton
- Department of Psychiatry, Massachusetts General Hospital / Harvard Medical School, Boston, MA, USA
| | - Greer A Raggio
- Department of Psychiatry, Massachusetts General Hospital / Harvard Medical School, Boston, MA, USA
- National Center for Weight and Wellness, Washington, D.C., USA
| | - Nzwakie Mosery
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Witwatersrand, Durban, South Africa
| | - Georgia R Goodman
- Department of Psychiatry, Massachusetts General Hospital / Harvard Medical School, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Elsa S Briggs
- Department of Health Systems & Population Health, University of Washington, Seattle, WA, USA
- Department of Community Health Science, Boston University, Boston, MA, USA
| | - Marcel Williams
- Howard University College of Medicine, Washington, D.C., USA
| | | | - Jenni Smit
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Witwatersrand, Durban, South Africa
| | - Steven A Safren
- Department of Psychology, University of Miami, Miami, FL, USA
| |
Collapse
|
9
|
Beesham I, Mansoor LE, Joseph Davey DL, Palanee-Phillips T, Smit J, Ahmed K, Selepe P, Louw C, Singata-Madliki M, Kotze P, Heffron R, Parikh UM, Wiesner L, Rees H, Baeten JM, Beksinska M. Brief Report: Quantifiable Plasma Tenofovir Among South African Women Using Daily Oral Pre-exposure Prophylaxis During the ECHO Trial. J Acquir Immune Defic Syndr 2022; 91:26-30. [PMID: 35972853 PMCID: PMC9377486 DOI: 10.1097/qai.0000000000003023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/16/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND HIV endpoint-driven clinical trials provide oral pre-exposure prophylaxis (PrEP) as HIV prevention standard of care. We evaluated quantifiable plasma tenofovir among South African women who used oral PrEP during the Evidence for Contraceptive Options and HIV Outcomes (ECHO) Trial. METHODS ECHO, a randomized trial conducted in 4 African countries between 2015 and 2018, assessed HIV incidence among HIV-uninfected women, aged 16-35 years, randomized to 1 of 3 contraceptives. Oral PrEP was offered onsite as part of the HIV prevention package at the South African trial sites. We measured tenofovir in plasma samples collected at the final trial visit among women reporting ongoing PrEP use. We used bivariate and multivariate logistical regression to assess demographic and sexual risk factors associated with plasma tenofovir quantification. RESULTS Of 260 women included, 52% were ≤24 years and 22% had Chlamydia trachomatis at enrollment. At PrEP initiation, 68% reported inconsistent/nonuse of condoms. The median duration of PrEP use was 90 days (IQR: 83-104). Tenofovir was quantified in 36% (n = 94) of samples. Women >24 years had twice the odds of having tenofovir quantified vs younger women (OR = 2.12; 95% confidence interval = 1.27 to 3.56). Women who reported inconsistent/nonuse of condoms had lower odds of tenofovir quantification (age-adjusted OR = 0.47; 95% confidence interval = 0.26 to 0.83). CONCLUSIONS Over a third of women initiating PrEP and reporting ongoing use at the final trial visit had evidence of recent drug exposure. Clinical trials may serve as an entry point for PrEP initiation among women at substantial risk for HIV infection with referral to local facilities for ongoing access at trial end. CLINICAL TRIAL NUMBER NCT02550067.
Collapse
Affiliation(s)
- Ivana Beesham
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Leila E. Mansoor
- Centre for AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
| | - Dvora L. Joseph Davey
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA
| | - Thesla Palanee-Phillips
- Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jenni Smit
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Khatija Ahmed
- Setshaba Research Centre, Soshanguve, South Africa
- Department of Medical Microbiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Cheryl Louw
- Madibeng Centre for Research, Brits, South Africa
- Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Mandisa Singata-Madliki
- Effective Care Research Unit, Universities of the Witwatersrand and Fort Hare and Eastern Cape Department of Health, East London, South Africa
| | - Philip Kotze
- Qhakaza Mbokodo Research Clinic, Ladysmith, South Africa;
| | - Renee Heffron
- Department of Global Health and Department of Epidemiology, University of Washington, Seattle, WA
| | - Urvi M. Parikh
- Department of Medicine, Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Lubbe Wiesner
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa;
| | - Helen Rees
- Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jared M. Baeten
- Department of Global Health, Department of Epidemiology, Department of Medicine, University of Washington, Seattle, WA; and
- Gilead Sciences, Foster City, CA
| | - Mags Beksinska
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| |
Collapse
|
10
|
Closson K, Ndungu J, Beksinska M, Ogilvie G, Dietrich JJ, Gadermann A, Gibbs A, Nduna M, Smit J, Gray G, Kaida A. Gender, Power, and Health: Measuring and Assessing Sexual Relationship Power Equity Among Young Sub-Saharan African Women and Men, a Systematic Review. Trauma Violence Abuse 2022; 23:920-937. [PMID: 33353490 DOI: 10.1177/1524838020979676] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Gender inequity, including low sexual relationship power (SRP), is an important determinant of intimate partner violence (IPV) and negative sexual, reproductive, and mental health. Different versions of the Sexual Relationship Power Scale (SRPS) are commonly used within youth studies to examine how gender inequities, including controlling behaviors, in heterosexual relationships impact the lives of young people in sub-Saharan Africa. This review aims to (1) describe definitions and measures of SRP within sub-Saharan African youth studies and (2) review and summarize associations between SRP equity, IPV, and sexual, reproductive, and mental health. After searching Pubmed, Ovid Med, Psych info, Web of Science, Google Scholar, and relevant research forums, 304 papers were identified, of which 29 papers based on 15 distinct studies (published 2004-2019) met our criteria for being youth-specific, conducted in sub-Saharan Africa, and including a quantitative measure of SRP. Details of each SRPS are described, including any adaptations and psychometric properties, as well as associations with IPV, sexual, reproductive, and mental health behaviors and outcomes. Results indicate that there are variations to the SRPS, and a paucity of evidence has detailed the psychometric properties of such measures within sub-Saharan African youth studies. Measures of SRP equity are associated with experiences (among women) and perpetration of (among men) IPV as numerous pathways to HIV risk; however, the evidence remains mixed. In order to address overlapping epidemics of violence against women and HIV, efforts are needed to ensure that measures, including the SRPS, are valid and reliable among highly affected populations.
Collapse
Affiliation(s)
- Kalysha Closson
- School of Population and Public Health, 8166The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jane Ndungu
- School of Behavioural & Lifestyle Sciences, 56723Nelson Mandela University, Port Elizabeth, South Africa
- Office of Engagement and Transformation, 56723Nelson Mandela University, Port Elizabeth, South Africa
| | - Mags Beksinska
- MatCH Research Unit (MRU), 37708Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Gina Ogilvie
- School of Population and Public Health, 8166The University of British Columbia, Vancouver, British Columbia, Canada
- Women's Health Research Institute (WHRI), BC Women's Health Centre, Vancouver, British Columbia, Canada
| | - Janan J Dietrich
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, 37707University of the Witwatersrand, Johannesburg, South Africa
- Health Systems Research Unit, South African Medical Research Unit, Cape Town, South Africa
| | - Anne Gadermann
- School of Population and Public Health, 8166The University of British Columbia, Vancouver, British Columbia, Canada
- The Human Learning Project, 8166The University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew Gibbs
- 59097South African Medical Research Council, Cape Town, South Africa
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Mzikazi Nduna
- Department of Psychology, 37707University of the Witwatersrand, Johannesburg, South Africa
| | - Jenni Smit
- MatCH Research Unit (MRU), 37708Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Glenda Gray
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, 37707University of the Witwatersrand, Johannesburg, South Africa
- 59097South African Medical Research Council, Cape Town, South Africa
| | - Angela Kaida
- Faculty of Health Sciences, 1763Simon Fraser University, Burnaby, British Columbia, Canada
| |
Collapse
|
11
|
Palanee-Phillips T, Rees HV, Heller KB, Ahmed K, Batting J, Beesham I, Heffron R, Justman J, Makkan H, Mastro TD, Morrison SA, Mugo N, Nair G, Kiarie J, Philip NM, Pleaner M, Reddy K, Selepe P, Steyn PS, Scoville CW, Smit J, Thomas KK, Donnell D, Baeten JM. High HIV incidence among young women in South Africa: Data from a large prospective study. PLoS One 2022; 17:e0269317. [PMID: 35657948 PMCID: PMC9165791 DOI: 10.1371/journal.pone.0269317] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 05/17/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction South Africa has the highest national burden of HIV globally. Understanding drivers of HIV acquisition in recently completed, prospective studies in which HIV was an endpoint may help inform the strategy and investments in national HIV prevention efforts and guide the design of future HIV prevention trials. We assessed HIV incidence and correlates of incidence among women enrolled in ECHO (Evidence for Contraceptive Options and HIV Outcomes), a large, open-label randomized clinical trial that compared three highly effective. reversible methods of contraception and rates of HIV acquisition. Methods During December 2015 to October 2018, ECHO followed sexually active, HIV-seronegative women, aged 16–35 years, seeking contraceptive services and willing to be randomized to one of three contraceptive methods (intramuscular depot medroxyprogesterone acetate, copper intrauterine device, or levonorgestrel implant) for 12–18 months at nine sites in South Africa. HIV incidence based on prospectively observed HIV seroconversion events. Cox proportional hazards regression models were used to define baseline cofactors related to incident HIV infection. Results 5768 women were enrolled and contributed 7647 woman-years of follow-up. The median age was 23 years and 62.5% were ≤24 years. A total of 345 incident HIV infections occurred, an incidence of 4.51 per 100 woman-years (95%CI 4.05–5.01). Incidence was >3 per 100 woman-years at all sites. Age ≤24 years, baseline infection with sexually transmitted infections, BMI≤30, and having new or multiple partners in the three months prior to enrollment were associated with incident HIV. Conclusions HIV incidence was high among South African women seeking contraceptive services. Integration of diagnostic management of sexually transmitted infections alongside delivery of HIV prevention options in health facilities providing contraception services are needed to mitigate ongoing risks of HIV acquisition for this vulnerable population. Clinical trial registration ClinicalTrials.gov, number NCT02550067 was the main Clinical Trial from which this secondary, non-randomized / observational analysis was derived with data limited to just South African sites.
Collapse
Affiliation(s)
- Thesla Palanee-Phillips
- Wits Reproductive Health and HIV Institute (Wits RHI), University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
- Departments of Global Health, Medicine and Epidemiology, University of Washington, Seattle, Washington, United States of America
- * E-mail:
| | - Helen V. Rees
- Wits Reproductive Health and HIV Institute (Wits RHI), University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
| | - Kate B. Heller
- Departments of Global Health, Medicine and Epidemiology, University of Washington, Seattle, Washington, United States of America
| | | | - Joanne Batting
- Effective Care Research Unit (ECRU), University of the Witwatersrand/Fort Hare, East London, South Africa
| | - Ivana Beesham
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Renee Heffron
- Departments of Global Health, Medicine and Epidemiology, University of Washington, Seattle, Washington, United States of America
| | - Jessica Justman
- Mailman School of Public Health, ICAP at Columbia University, New York, New York, United States of America
| | - Heeran Makkan
- Klerksdorp Clinical Research Centre, The Aurum Institute, Johannesburg, South Africa
| | | | - Susan A. Morrison
- Departments of Global Health, Medicine and Epidemiology, University of Washington, Seattle, Washington, United States of America
| | - Nelly Mugo
- Departments of Global Health, Medicine and Epidemiology, University of Washington, Seattle, Washington, United States of America
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Gonasagrie Nair
- Emavundleni Research Centre, University of Cape Town, Cape Town, South Africa
- Department of Medicine, Faculty of Medicine and Health Sciences, Centre for Medical Ethics and Law, Stellenbosch University, Stellenbosch, South Africa
| | - James Kiarie
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Neena M. Philip
- Mailman School of Public Health, ICAP at Columbia University, New York, New York, United States of America
| | - Melanie Pleaner
- Wits Reproductive Health and HIV Institute (Wits RHI), University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
| | - Krishnaveni Reddy
- Wits Reproductive Health and HIV Institute (Wits RHI), University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
| | - Pearl Selepe
- Klerksdorp Clinical Research Centre, The Aurum Institute, Johannesburg, South Africa
| | - Petrus S. Steyn
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | | | - Jenni Smit
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Katherine K. Thomas
- Departments of Global Health, Medicine and Epidemiology, University of Washington, Seattle, Washington, United States of America
| | - Deborah Donnell
- Departments of Global Health, Medicine and Epidemiology, University of Washington, Seattle, Washington, United States of America
| | - Jared M. Baeten
- Departments of Global Health, Medicine and Epidemiology, University of Washington, Seattle, Washington, United States of America
- Gilead Sciences, Foster City, California, United States of America
| | | |
Collapse
|
12
|
Zhao X, Milford C, Smit J, Zulu B, Boyd P, Malcolm RK, Beksinska M. Color, Scent and Size: Exploring Women's Preferences Around Design Characteristics of Drug-Releasing Vaginal Rings. AIDS Behav 2022; 26:2954-2968. [PMID: 35294694 PMCID: PMC8924943 DOI: 10.1007/s10461-022-03596-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2022] [Indexed: 11/30/2022]
Abstract
Steroid-releasing vaginal rings are available for contraception and estrogen replacement therapy, and a new antiretroviral-releasing ring was recently approved for HIV prevention. Marketed rings are white or transparent in appearance, non-scented, and supplied as one-size-fits-all devices with diameters ranging from 54 to 56 mm. In this study, drug-free silicone elastomer rings were manufactured in different sizes, colors and scents, and the opinions/preferences of 16 women (eThekwini District, South Africa; 20–34 years) assessed through focus group discussions and thematic analysis. Opinions varied on ring color and scent, with some women preferring specific colors or scent intensities, while for others these attributes were unimportant. Concerns about color and scent were linked to perceptions around vaginal health and safety related to chemical composition. There was greater agreement on preferred ring size; flexibility and width were considered important factors for insertion and comfort. Greater choice with ring products could facilitate acceptability and overall uptake.
Collapse
Affiliation(s)
- Xinyu Zhao
- School of Pharmacy, Queen’s University Belfast, Belfast, BT9 7BL UK
| | - Cecilia Milford
- MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Jenni Smit
- MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Bongiwe Zulu
- MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Peter Boyd
- School of Pharmacy, Queen’s University Belfast, Belfast, BT9 7BL UK
| | - R. Karl Malcolm
- School of Pharmacy, Queen’s University Belfast, Belfast, BT9 7BL UK
| | - Mags Beksinska
- MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| |
Collapse
|
13
|
Feitz R, Stip D, van der Oest M, Souer S, Hovius S, Selles R, Blomme R, Sluijter B, van der Avoort D, Kroeze A, Smit J, Debeij J, Walbeehm E, van Couwelaar G, Vermeulen GM, de Schipper J, Temming J, van Uchelen J, de Boer H, de Haas K, Harmsen K, Zöphel O, Koch R, Moojen T, Smit X, van Huis R, Pennehouat P, Schoneveld K, van Kooij Y, Wouters R, Veltkamp J, Fink A, de Ridder W, Poelstra R, Slijper H, Selles R, Tsehaie J, Janssen M, Sun P, Schrier V, Hoogendam L, Dekker J, Jansen-Landheer M, Stege MT. Prognostic Factors in Open Triangular Fibrocartilage Complex (TFCC) Repair. Journal of Hand Surgery Global Online 2021; 3:176-181. [PMID: 35415558 PMCID: PMC8991529 DOI: 10.1016/j.jhsg.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/08/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose Patients with triangular fibrocartilage complex (TFCC) injury report ulnar-sided wrist pain and impaired function. Open TFCC repair aims to improve the condition of these patients. Patients have shown reduction in pain and improvement in function at 12 months after surgery; however, results are highly variable. The purpose of this study was to relate patient (eg, age and sex), disease (eg, trauma history and arthroscopic findings), and surgery factors (type of bone anchor) associated with pain and functional outcomes at 12 months after surgery. Methods This study included patients who underwent an open TFCC repair between December 2011 and December 2018 in various Xpert Clinics in the Netherlands. All patients were asked to complete Patient-Rated Wrist Evaluation (PRWE) questionnaires at baseline as well as at 12 months after surgery. Patient, disease, and surgery factors were extracted from digital patient records. All factors were analyzed by performing a multivariable hierarchical linear regression. Results We included 274 patients who had received open TFCC repair and completed PRWE questionnaires. Every extra month of symptoms before surgery was correlated with an increase of 0.14 points on the PRWE total score at 12 months after surgery. In addition, an increase of 0.28 points in the PRWE total score at 12 months was seen per extra point of PRWE total score at baseline. Conclusions Increased preoperative pain, less preoperative function, and a longer duration of complaints are factors that were associated with more pain and less function at 12 months after open surgery for TFCC. This study arms surgeons with data to predict outcomes for patients undergoing open TFCC repair. Type of study/level of evidence Prognostic II.
Collapse
|
14
|
Beksinska M, Issema R, Beesham I, Lalbahadur T, Thomas K, Morrison C, Hofmeyr G, Steyn PS, Mugo N, Palanee-Phillips T, Ahmed K, Nair G, Baeten JM, Smit J. Weight change among women using intramuscular depot medroxyprogesterone acetate, a copper intrauterine device, or a levonorgestrel implant for contraception: Findings from a randomised, multicentre, open-label trial. EClinicalMedicine 2021; 34:100800. [PMID: 33898953 PMCID: PMC8056402 DOI: 10.1016/j.eclinm.2021.100800] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND There is limited evidence on the impact of the use of progestin-only hormonal contraception (POC) on weight change. We conducted a secondary analysis of prospective weight change among women enrolled in the Evidence for Contraceptive options and HIV Outcomes (ECHO) trial. METHODS The ECHO trial was conducted at 12 sites in eSwatini, Kenya, South Africa and Zambia between December 2015 and October 2018. HIV negative, women aged 16-35 years, desiring contraception, were randomised (1:1:1) to either 3-monthly intramuscular depot medroxyprogesterone acetate (DMPA-IM), levonorgestrel (LNG) implant or copper intrauterine device (IUD). Follow-up was up to 18 months. Weight (kg) was measured at baseline and study exit. Analysis was performed as intention to treat (ITT) and time on continuous contraceptive use. The primary outcome of this secondary analysis is weight change from study enrolment to the final visit at study month 12-18. The ECHO trial is registered with ClinicalTrials.gov, NCT02550067. FINDINGS 7829 women were randomly assigned to DMPA-IM (n = 2609), copper IUD (n = 2607) or LNG implant (n = 2613). The ITT population included 7014 women 2293 DMPA-IM group, 2372 copper IUD group and 2349 LNG group) who were not lost to follow-up, pregnant on study, or missing weight data. The mean weight increased in all groups but was significantly different in magnitude: 3.5 kg (SD = 6.3), 2.4 kg (SD = 5.9) and 1.5 kg (SD = 5.7) in the DMPA-IM, LNG implant and copper IUD groups, respectively. Comparative differences between groups were (2.02 kg (95% CI, 1.68, 2.36, p < 0.001) for DMPA-IM versus copper IUD, 0.87 kg (0.53,1.20 p < 0.001) for LNG implant compared to copper IUD and 1.16 kg (0.82, 1.50, p < 0.001) for DMPA-IM compared with LNG implant. Results for continuous contraceptive use were similar. INTERPRETATION We found differences in weight gain between POC users compared to the non-hormonal copper IUD group over 12-18 months of use. Women using POCs should be counselled about this potential side effect when choosing a contraceptive method.
Collapse
Affiliation(s)
- Mags Beksinska
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
- Corresponding author.
| | - Rodal Issema
- Department of Epidemiology, University of Washington, Seattle, WA 98104, United States
| | - Ivana Beesham
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Tharnija Lalbahadur
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Katherine Thomas
- Department of Global Health, University of Washington, Seattle, WA 98104, United States
| | | | - G.Justus Hofmeyr
- Effective Care Research Unit, University of the Witwatersrand, Walter Sisulu University, East London, South Africa; University of Botswana, Gaborone, Botswan
| | - Petrus S. Steyn
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Nelly Mugo
- Department of Global Health, University of Washington, Seattle, WA 98104, United States
- Center for Clinical Research (CCR), Kenya Medical Research Institute (KEMRI), Kenya
| | - Thesla Palanee-Phillips
- University of the Witwatersrand, Wits Reproductive Health and HIV Institute (Wits RHI), Johannesburg, South Africa
| | - Khatija Ahmed
- Setshaba Research Centre, Soshanguve, South Africa
- Faculty of Health Sciences, Department of Medical Microbiology, University of Pretoria
| | | | - Jared M. Baeten
- Department of Global Health, University of Washington, Seattle, WA 98104, United States
| | - Jenni Smit
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| |
Collapse
|
15
|
Beesham I, Heffron R, Evans S, Baeten JM, Smit J, Beksinska M, Mansoor LE. Exploring the Use of Oral Pre-exposure Prophylaxis (PrEP) Among Women from Durban, South Africa as Part of the HIV Prevention Package in a Clinical Trial. AIDS Behav 2021; 25:1112-1119. [PMID: 33106996 PMCID: PMC7973915 DOI: 10.1007/s10461-020-03072-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2020] [Indexed: 01/21/2023]
Abstract
HIV endpoint-driven clinical trials in Africa enroll women who are at heightened risk of acquiring HIV. In 2017, the South African Medical Research Council recommended the provision of oral pre-exposure prophylaxis (PrEP) in HIV prevention trials, at which time the Evidence for Contraceptive Options and HIV Outcomes trial was ongoing and began to provide PrEP on-site at some trial sites. We interviewed 132 women who initiated PrEP on-site at the Durban, South Africa trial site to explore PrEP use, and conducted phone-based interviews 4-6 months post-trial exit to explore post-trial PrEP access. PrEP uptake was high (42.6%). Among women initiating PrEP on-site, 87.9% felt at risk of acquiring HIV. Most women (> 90%) heard of PrEP for the first time from study staff and three-quarters who initiated PrEP on-site continued at trial-exit. PrEP use declined post-trial exit with more than 50% of women discontinuing PrEP, and barriers relating to access emerged.
Collapse
Affiliation(s)
- Ivana Beesham
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa.
| | - Renee Heffron
- Department of Global Health, Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Shannon Evans
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Jared M Baeten
- Department of Global Health, Department of Epidemiology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Jenni Smit
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Mags Beksinska
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Leila E Mansoor
- Centre for AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
16
|
Jesson J, Dietrich J, Beksinska M, Closson K, Nduna M, Smit J, Brockman M, Ndung'u T, Gray G, Kaida A. Food insecurity and depression: a cross-sectional study of a multi-site urban youth cohort in Durban and Soweto, South Africa. Trop Med Int Health 2021; 26:687-700. [PMID: 33666301 DOI: 10.1111/tmi.13572] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To assess the prevalence of food insecurity and the independent association between depression and food insecurity among youth living in two urban settings in South Africa. METHODS Baseline cross-sectional survey data was analysed from a prospective cohort study conducted between 2014 and 2016 among youth (aged 16-24 years) in Soweto and Durban. Interviewer-administered questionnaires collecting socio-demographic, sexual and reproductive health and mental health data were conducted. Household food insecurity was measured using the 3-item Household Hunger Scale, with food insecure participants defined as having 'moderate' or 'severe hunger' compared to 'no hunger'. Depression was assessed using the 10-item Center for Epidemiological Studies Depression (CES-D 10) Scale (range 0-30, probable depression ≥ 10). Multivariable logistic regression models were used to estimate the association between depression and food insecurity. RESULTS There were 422 participants. Median age was 19 years (interquartile range [IQR] 18-21) and 60% were women. Overall, 18% were food insecure and 42% had probable depression. After adjustment for socio-demographic variables (age, gender, female-headed household, household size and school enrolment), participants with probable depression had higher odds of being food insecure than non-depressed participants (2.79, 95%CI 1.57-4.94). CONCLUSION Nearly one-fifth of youth in this study were food insecure. Those with probable depression had increased odds of food insecurity. Interventions are needed to address food insecurity among urban youth in South Africa, combining nutritional support and better access to quality food with mental health support.
Collapse
Affiliation(s)
- Julie Jesson
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Janan Dietrich
- Perinatal HIV Research Unit (PHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Mags Beksinska
- Maternal Adolescent and Child Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Kalysha Closson
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Mzikazi Nduna
- Department of Psychology, University of the Witwatersrand, Johannesburg, South Africa
| | - Jenni Smit
- Maternal Adolescent and Child Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Mark Brockman
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Thumbi Ndung'u
- HIV Pathogenesis Programme and Africa Health Research Institute, University of KwaZulu-Natal, Durban, South Africa.,Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA.,Max Planck Institute for Infection Biology, Berlin, Germany.,Division of Infection and Immunity, University College London, London, UK
| | - Glenda Gray
- Perinatal HIV Research Unit (PHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Office of the President, South African Medical Research Council, Cape Town, South Africa
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| |
Collapse
|
17
|
Pakhomova TE, Dietrich JJ, Closson K, Smit J, Hornschuh S, Smith P, Beksinska M, Ndung'u T, Brockman M, Gray G, Kaida A. Intimate Partner Violence, Depression, and Anxiety Are Associated With Higher Perceived Stress Among Both Young Men and Women in Soweto and Durban, South Africa. Front Reprod Health 2021; 3:638116. [PMID: 36304031 PMCID: PMC9580652 DOI: 10.3389/frph.2021.638116] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 02/19/2021] [Indexed: 12/14/2022] Open
Abstract
Objectives: Psychological stress is an important determinant of health, including for mental well-being and sexual health. However, little is known about the prevalence and psychosocial and sexual health correlates of perceived stress among young people in South Africa, where elevated life-stressors are an important driver of health inequities. This study examines the association between intimate partner violence (IPV), psychosocial and sexual health, and perceived stress, by gender, among South African adolescents and young adults. Methods: Using baseline survey data from AYAZAZI, a cohort study enrolling youth (16–24 years) from Durban and Soweto, we used the 10-item Perceived Stress Scale (PSS-10) to measure the degree to which an individual perceives their life situations as unpredictable, uncontrollable, and overloaded. Possible scores range between 0 and 40; higher scores indicating higher perceived stress. Crude and adjusted gender-stratified linear regression models examined associations between sexual health factors, experiences (young women) and perpetration (young men) of IPV, anxiety (APA 3-item Scale, ≥2 = probable anxiety), and depression (10-item CES-D Scale, ≥10 = probable depression) and perceived stress. Multivariable models adjusted for age, income, sexual orientation, and financial dependents. Results: Of the 425 AYAZAZI participants, 60% were young women. At baseline, 71.5% were students//learners and 77.2% earned ≤ ZAR1600 per month (~$100 USD). The PSS-10 had moderate reliability (α = 0.70 for young women, 0.64 for young men). Young women reported significantly higher mean PSS scores than young men [18.3 (6.3) vs. 16.4 (6.0)]. In adjusted linear regression models, among young women experiences of IPV (β = 4.33; 95% CI: 1.9, 6.8), probable depression (β = 6.63; 95% CI: 5.2, 8.1), and probable anxiety (β = 5.2; 95% CI: 3.6, 6.8) were significantly associated with higher PSS scores. Among young men, ever perpetrating IPV (β = 2.95; 95% CI: 0.3, 5.6), probable depression (β = 6; 95% CI: 4.3, 7.6), and probable anxiety (β = 3.9; 95% CI: 2.1, 5.8) were significantly associated with higher perceived stress. Conclusion: We found that probable depression, anxiety, perpetration of IPV among young men, and experiences of IPV among young women, were associated with higher perceived stress. Critical efforts are needed to address the gendered stressors of young men and women and implement services to address mental health within violence prevention efforts.
Collapse
Affiliation(s)
| | - Janan Janine Dietrich
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Kalysha Closson
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Jenni Smit
- Maternal Adolescent and Child Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Stefanie Hornschuh
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Patricia Smith
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Mags Beksinska
- Maternal Adolescent and Child Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Thumbi Ndung'u
- Africa Health Research Institute, Durban, South Africa
- HIV Pathogenesis Programme, The Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
- Max Planck Institute for Infection Biology, Berlin, Germany
- Division of Infection and Immunity, University College London, London, United Kingdom
| | - Mark Brockman
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Glenda Gray
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- Office of the President, South African Medical Research Council, Cape Town, South Africa
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- *Correspondence: Angela Kaida
| |
Collapse
|
18
|
Dietrich JJ, Otwombe K, Pakhomova TE, Horvath KJ, Hornschuh S, Hlongwane K, Closson K, Mulaudzi M, Smith P, Beksinska M, Gray GE, Brockman M, Smit J, Kaida A. High cellphone use associated with greater risk of depression among young women aged 15-24 years in Soweto and Durban, South Africa. Glob Health Action 2021; 14:1936792. [PMID: 34431754 PMCID: PMC8405067 DOI: 10.1080/16549716.2021.1936792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND The ubiquity of cellular phone (cellphone) use in young people's daily lives has emerged as a priority area of concern for youth mental health. OBJECTIVE This study measured the prevalence of depression and its association with high cellphone use among youth in Soweto and Durban, South Africa. METHODS We analysed cross-sectional, baseline survey data among youth aged 16-24 who participated in a dual-site cohort study, 'AYAZAZI', conducted from 2014 to 2017. The primary outcome was depression using the 10-item Center for Epidemiologic Studies Depression Scale, with a score of ≥ 10 indicating probable depression. Cellphone use was measured via self-reported average number of hours of active use, with 'high cellphone use' defined as daily usage of ≥ 8. Multivariable logistic regression models assessed the independent relationship between high cellphone use and probable depression, adjusting for potential confounders. RESULTS Of 425 participants with a median age of 19 years (IQR = 18-21), 59.5% were young women. Overall, 43.3% had probable depression, with a higher prevalence among women (49.0% vs. 34.9%, P = .004). Nearly all (94.6%) owned a cellphone. About one-third (29.5%) reported spending ≥ 8 hours per day using their cellphone (39.3% of women vs. 14.9% of men, P < .001). In the overall adjusted model, youth reporting high daily cellphone use had higher odds of probable depression (aOR: 1.83, 95% CI: 1.16-2.90). In gender-stratified models, high daily cellphone use was associated with probable depression among women (aOR: 2.51, 95% CI: 1.47-4.31), but not among men (aOR: 0.87, 95% CI: 0.35-2.16). CONCLUSIONS Among a cohort of South African youth, we found a high prevalence of probable depression and high cellphone use (30%). The findings indicate a need for intersectoral initiatives focused on meaningful mental health support for South African youth to support positive growth and development.
Collapse
Affiliation(s)
- Janan J Dietrich
- Perinatal HIV Research Unit (PHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,African Social Sciences Unit of Research and Evaluation (ASSURE), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa and Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Kennedy Otwombe
- Perinatal HIV Research Unit (PHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Keith J Horvath
- San Diego State University, Department of Psychology, San Diego, California, United States
| | - Stefanie Hornschuh
- Perinatal HIV Research Unit (PHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Khuthadzo Hlongwane
- Perinatal HIV Research Unit (PHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Kalysha Closson
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Mamakiri Mulaudzi
- Perinatal HIV Research Unit (PHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Patricia Smith
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Mags Beksinska
- MatCH Research Unit (MRU), Department of Gynaecology and Obstetrics, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Glenda E Gray
- Perinatal HIV Research Unit (PHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Office of the President, South African Medical Research Council, Cape Town, South Africa
| | - Mark Brockman
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Jenni Smit
- MatCH Research Unit (MRU), Department of Gynaecology and Obstetrics, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| |
Collapse
|
19
|
Musara P, Milford C, Shapley-Quinn MK, Weinrib R, Mutero P, Odoom E, Mgodi NM, Chirenje ZM, Hanif H, Clark MR, Smit J, van der Straten A, Montgomery ET. Preferences and Acceptability of Vaginal Delivery Forms for HIV Prevention Among Women, Male Partners and Key Informants in South Africa and Zimbabwe: Qualitative Findings. AIDS Behav 2021; 25:124-138. [PMID: 32588257 DOI: 10.1007/s10461-020-02949-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The attributes of an HIV microbicide may affect its acceptability, uptake and use. Quatro, a clinical study with a qualitative component, was conducted to elicit input from end-users and key informants (KIs) on four different placebo vaginal microbicide delivery forms; fast dissolving insert, ring, film and gel. In-depth interviews and focus group discussions were conducted with young women, their male partners and KIs, to explore acceptability and preferences of the four placebo products, with the intention of improving product attributes, adherence, and consequently, long term effectiveness. None of the four microbicide delivery forms stood well above others as the most preferred. Product attributes; long-action, ease of use, invisibility, female initiated and non-interference during sex were favourable in both countries. Despite preference for the long-action, on-demand products were the most liked by women. Qualitative data from the Quatro study provided rich feedback on specific attributes important to the acceptability of four HIV prevention product platforms currently in development, enabling more informed and guided product development efforts moving forward.
Collapse
Affiliation(s)
- Petina Musara
- University of Zimbabwe College of Health Sciences-Clinical Trials Research Centre, 15 Phillips Avenue, Belgravia, Harare, Zimbabwe.
| | - Cecilia Milford
- MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | | | - Rachel Weinrib
- Women's Global Health Imperative, RTI International, San Francisco, CA, USA
| | - Prisca Mutero
- University of Zimbabwe College of Health Sciences-Clinical Trials Research Centre, 15 Phillips Avenue, Belgravia, Harare, Zimbabwe
| | - Enyonam Odoom
- Women's Global Health Imperative, RTI International, San Francisco, CA, USA
| | - Nyaradzo M Mgodi
- University of Zimbabwe College of Health Sciences-Clinical Trials Research Centre, 15 Phillips Avenue, Belgravia, Harare, Zimbabwe
| | - Zvavahera M Chirenje
- University of Zimbabwe College of Health Sciences-Clinical Trials Research Centre, 15 Phillips Avenue, Belgravia, Harare, Zimbabwe
| | - Homaira Hanif
- Eastern Virginia Medical School, CONRAD, Arlington, VA, USA
| | | | - Jenni Smit
- MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Ariane van der Straten
- Women's Global Health Imperative, RTI International, San Francisco, CA, USA
- Center for AIDS Prevention Studies, University of San Francisco, San Francisco, CA, USA
| | | |
Collapse
|
20
|
Beksinska M, Lulie B, Beesham I, Smit J. Pubic hair grooming practices in KwaZulu-Natal, South Africa: prevalence, side effects and association with sexually transmitted infections. Int J STD AIDS 2020; 31:1034-1039. [PMID: 32753000 DOI: 10.1177/0956462420941709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pubic hair grooming is common in many countries, but little is known about this practice in Africa. Grooming has been positively associated with self-reported sexually transmitted infections (STIs). This study aimed to investigate the prevalence and safety of pubic hair grooming in two South African settings. In KwaZulu-Natal province, 1218 women participating in the Evidence for Contraceptive Options and HIV Outcomes Trial completed an interviewer-administered questionnaire on pubic hair grooming practices, and were tested for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and herpes simplex virus type 2 (HSV-2). Pubic hair removal was reported by 705 (58.2%) of women. Common areas for grooming were the pubis (n = 616, 99.4%), vagina/perineum (n = 529, 85.3%) and inner thigh (n = 255, 41.1%). Half (n= 361, 51.4%) removed some or all of their pubic hair at least monthly and 59 (8.4%) once a week or more often. Common side effects reported included itching (n = 439, 77.1%) and pimples and blisters (n = 249, 43.9%). A quarter (n = 173, 24.5%) of groomers had a positive result for either or both of CT and NG compared to a fifth (n = 98, 19.4%) of non-groomers (p-value < 0.033). There was no difference between the groups for HSV-2. After adjusting for age and having more than one sex partner, groomers were significantly more likely to have CT or NG than non-groomers (OR: 1.31; 95% CI: 1.19-1.45). Similarly, those who experienced hair removal-related complications had 1.26 times the odds of testing positive for CT or NG (95% CI: 1.03-1.54). The practice of pubic hair removal is common and reporting of side effects is high in this population. These injuries could put women at a higher risk of STIs.
Collapse
Affiliation(s)
- Mags Beksinska
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Bethel Lulie
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Ivana Beesham
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Jenni Smit
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| |
Collapse
|
21
|
El Mahdiui M, Smit J, van Rosendael A., Neglia D, Knuuti J, Saras A, Buechel R, Teresinska A, Pizzi M, Poddighe R, Mertens B, Caselli C, Rocchiccioli S, Parodi O, Pelosi W, Scholte A. Sex Differences In The Natural History Of Coronary Plaque Changes By Serial Coronary Computed Tomography Angiography. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
22
|
Chitneni P, Beksinska M, Dietrich JJ, Jaggernath M, Closson K, Smith P, Lewis DA, Matthews LT, Smit J, Ndung’u T, Brockman M, Gray G, Kaida A. Partner notification and treatment outcomes among South African adolescents and young adults diagnosed with a sexually transmitted infection via laboratory-based screening. Int J STD AIDS 2020; 31:627-636. [PMID: 32403988 PMCID: PMC7357572 DOI: 10.1177/0956462420915395] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Partner notification and treatment are essential components of sexually transmitted infection (STI) management, but little is known about such practices among adolescents and young adults. Using data from a prospective cohort study (AYAZAZI) of youth aged 16-24 years in Durban, South Africa, we assessed the STI care cascade across participant diagnosis, STI treatment, partner notification, and partner treatment; index recurrent STI and associated factors; and reasons for not notifying partner of STI. Participants completed laboratory-based STI screening (Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis) at enrollment and at 12 months. Of the 37/216 participants with STI (17%), 27/37 (73%) were women and 10/37 (27%) were men. Median age was 19 years (IQR: 18-20). Of the participants with STI, 23/37 (62%) completed a Treatment and Partner Tracing Survey within 6 months of diagnosis. All survey participants reported completing STI treatment (100%), 17/23 (74%) notified a partner, and 6/23 (35%) reported partner treatment. Overall, 4/23 (11%) participants had 12-month recurrent C. trachomatis infection, with no association with partner notification or treatment. Stigma and lack of STI knowledge were reasons for not notifying partner of STI. STI partner notification and treatment is a challenge among youth. Novel strategies are needed to overcome barriers along the STI care cascade.
Collapse
Affiliation(s)
- Pooja Chitneni
- Brigham and Women’s Hospital and Massachusetts General Hospital combined Infectious Diseases Fellowship, Boston, MA, USA
| | - Mags Beksinska
- Maternal Adolescent and Child Health (MatCH) Research Unit (MRU), University of the Witwatersrand, Faculty of Health Sciences, Durban, South Africa
| | - Janan J. Dietrich
- Perinatal HIV Research Unit (PHRU), University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
| | - Manjeetha Jaggernath
- Maternal Adolescent and Child Health (MatCH) Research Unit (MRU), University of the Witwatersrand, Faculty of Health Sciences, Durban, South Africa
| | - Kalysha Closson
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Patricia Smith
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - David A. Lewis
- Westmead Clinical School, Faculty of Medicine and Health & Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
- Division of Medical Virology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Lynn T. Matthews
- University of Alabama at Birmingham: Division of Infectious Diseases, Birmingham, AL, USA
| | - Jenni Smit
- Maternal Adolescent and Child Health (MatCH) Research Unit (MRU), University of the Witwatersrand, Faculty of Health Sciences, Durban, South Africa
| | - Thumbi Ndung’u
- HIV Pathogenesis Programme and Africa Health Research Institute, University of KwaZulu-Natal, Durban, South Africa
- Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
- Max Planck Institute for Infection Biology, Berlin, Germany
| | - Mark Brockman
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Glenda Gray
- Perinatal HIV Research Unit (PHRU), University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
- South African Medical Research Council, Cape Town, South Africa
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| |
Collapse
|
23
|
Onono M, Nanda K, Heller KB, Taylor D, Yacobson I, Heffron R, Kasaro MP, Louw CE, Nhlabasti Z, Palanee-Phillips T, Smit J, Wakhungu I, Gichangi PB, Mugo NR, Morrison C, Baeten JM. Comparison of pregnancy incidence among African women in a randomized trial of intramuscular depot medroxyprogesterone acetate (DMPA-IM), a copper intrauterine device (IUDs) or a levonorgestrel (LNG) implant for contraception. Contracept X 2020; 2:100026. [PMID: 32577615 PMCID: PMC7301167 DOI: 10.1016/j.conx.2020.100026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/14/2020] [Accepted: 05/17/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The objective was to address bias in contraception efficacy studies through a randomized study trial of intramuscular depot medroxyprogesterone acetate (DMPA-IM), a copper intrauterine device (IUDs) and a levonorgestrel (LNG) implant. STUDY DESIGN We analyzed data from the Evidence for Contraceptive Options and HIV Outcomes Trial, which assessed HIV incidence among 7829 women from 12 sites in eSwatini, Kenya, South Africa and Zambia seeking effective contraception and who consented to be randomized to DMPA-IM, copper IUD or LNG implant. We used Cox proportional hazards regression adjusted for condom use to compare pregnancy incidence during both perfect and typical (i.e., allowing temporary interruptions) use. RESULTS A total of 7710 women contributed to this analysis. Seventy pregnancies occurred during perfect and 85 during typical use. There was no statistically significant difference in perfect use pregnancy incidence among the methods: 0.61 per 100 woman-years for DMPA-IM [95% confidence interval (CI) 0.36-0.96], 1.06 for copper IUD (95% CI 0.72-1.50) and 0.63 for LNG implants (95% CI 0.39-0.96). Typical use pregnancy rates were also largely similar: 0.87 per 100 woman-years for DMPA-IM (95% CI 0.58-1.25), 1.11 for copper IUD (95% CI 0.77-1.54) and 0.63 for LNG implants (95% CI 0.39-0.96). CONCLUSIONS In this randomized trial of highly effective contraceptive methods among African women, both perfect and typical use resulted in low pregnancy rates. Our findings provide strong justification for improving access to a broader range of longer-acting contraceptive options including LNG implants and copper IUD for African women. IMPLICATIONS STATEMENT Data from this study support recommendations to providers, policy makers and patients that all of these methods provide safe and highly effective contraception for African women.
Collapse
Affiliation(s)
- Maricianah Onono
- Kenya Medical Research Institute Center for Microbiology Research, P.O. Box 19464-00202, Nairobi, Kenya
| | | | | | | | | | | | | | - Cheryl E. Louw
- Madibeng Centre for Research, Brits, South Africa
- Department of Family Medicine, University of Pretoria, Pretoria, South Africa
| | - Zelda Nhlabasti
- Family Life Association of eSwatini & ICAP at Columbia University, eSwatini
| | - Thesla Palanee-Phillips
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, School of Clinical Medicine, Johannesburg, South Africa
| | - Jenni Smit
- University of the Witwatersrand, Durban, South Africa
| | - Imelda Wakhungu
- Kenya Medical Research Institute Center for Microbiology Research, P.O. Box 19464-00202, Nairobi, Kenya
| | - Peter B. Gichangi
- International Center for Reproductive Health, Kenya
- Technical University of Mombasa, Mombasa, Kenya
| | - Nelly R. Mugo
- Kenya Medical Research Institute Center for Microbiology Research, P.O. Box 19464-00202, Nairobi, Kenya
- University of Washington, Seattle, USA
| | | | | | - for the Evidence for Contraceptive Options and HIV Outcomes (ECHO) Trial Consortium
- Kenya Medical Research Institute Center for Microbiology Research, P.O. Box 19464-00202, Nairobi, Kenya
- FHI 360, Durham, USA
- University of Washington, Seattle, USA
- UNC Global Projects Zambia & University of North Carolina at Chapel Hill, Zambia
- Madibeng Centre for Research, Brits, South Africa
- Department of Family Medicine, University of Pretoria, Pretoria, South Africa
- Family Life Association of eSwatini & ICAP at Columbia University, eSwatini
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, School of Clinical Medicine, Johannesburg, South Africa
- University of the Witwatersrand, Durban, South Africa
- International Center for Reproductive Health, Kenya
- Technical University of Mombasa, Mombasa, Kenya
| |
Collapse
|
24
|
Browne EN, Montgomery ET, Mansfield C, Boeri M, Mange B, Beksinska M, Schwartz JL, Clark MR, Doncel GF, Smit J, Chirenje ZM, van der Straten A. Efficacy is Not Everything: Eliciting Women's Preferences for a Vaginal HIV Prevention Product Using a Discrete-Choice Experiment. AIDS Behav 2020; 24:1443-1451. [PMID: 31696371 PMCID: PMC6990865 DOI: 10.1007/s10461-019-02715-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
As new female-initiated HIV prevention products enter development, it is crucial to incorporate women’s preferences to ensure products will be desired, accepted, and used. A discrete-choice experiment was designed to assess the relative importance of six attributes to stated choice of a vaginally delivered HIV prevention product. Sexually active women in South Africa and Zimbabwe aged 18–30 were recruited from two samples: product-experienced women from a randomized trial of four vaginal placebo forms and product-naïve community members. In a tablet-administered survey, 395 women chose between two hypothetical products over eight choice sets. Efficacy was the most important, but there were identifiable preferences among other attributes. Women preferred a product that also prevented pregnancy and caused some wetness (p < 0.001). They disliked a daily-use product (p = 0.002) and insertion by finger (p = 0.002). Although efficacy drove preference, wetness, pregnancy prevention, and dosing regimen were influential to stated choice of a product, and women were willing to trade some level of efficacy to have other more desired attributes.
Collapse
Affiliation(s)
- Erica N Browne
- Women's Global Health Imperative, RTI International, 351 California Street, Suite 500, San Francisco, CA, 94104, USA.
| | - Elizabeth T Montgomery
- Women's Global Health Imperative, RTI International, 351 California Street, Suite 500, San Francisco, CA, 94104, USA
| | - Carol Mansfield
- Health Solutions, RTI International, Research Triangle Park, NC, USA
| | - Marco Boeri
- Health Solutions, RTI International, Research Triangle Park, NC, USA
| | - Brennan Mange
- Health Solutions, RTI International, Research Triangle Park, NC, USA
| | - Mags Beksinska
- MatCH Research Unit (MRU), Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | | | | | | | - Jenni Smit
- MatCH Research Unit (MRU), Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Zvavahera M Chirenje
- University of Zimbabwe College of Health Sciences Clinical Trials Research Centre, Harare, Zimbabwe
| | - Ariane van der Straten
- Women's Global Health Imperative, RTI International, 351 California Street, Suite 500, San Francisco, CA, 94104, USA
- Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, CA, USA
| |
Collapse
|
25
|
Anholt G, Cath D, van Oppen P, Eikelenboom M, Smit J, van Megen H, van Balkom A. Do ADHD and Autism Symptoms Predict Specific OC Symptom Dimensions from OC Symptom Severity in OCD? Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(09)71262-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Backgrond:Autism spectrum disorder (ASD) symptoms and attention deficit/ hyperactivity disorder (ADHD) symptoms are frequently comorbid with obsessive-compulsive disorder (OCD). However, limited research exists with respect to the relations between these symptoms, and their impact on OC symptom severity.Method:109 outpatients with primary OCD and 87 healthy controls were administered OCD, ADHD, and ASD questionnaires. Univariate analyses, correlations, and stepwise regression analyses were conducted.Results:OCD, ADHD, and autism symptoms were highly correlated, with OCD patients showing elevated ADHD as well as autism scores when compared with healthy controls. OCD patients with comorbid ADHD presented with higher autism symptoms and OCD symptoms, yet similar OCD severity scores as OCD without ADHD patients. the attention switching and lack of social skills subscales of the Autism Questionnaire (AQ) were particularly correlated with ADHD and OCD symptoms in the patient group. the AQ subscale attention switching proved to be the most significant predictor of OCD severity and symptoms (with the exception of hoarding). Contrary to expectations, the AQ subscale attention to detail did not predict OCD symptoms, nor did any of the AQ subscale scores predict hoarding symptoms.Conclusions:OCD patients present with elevated scores of ADHD and ASD symptoms, and these symptoms (particularly attention switching) are important in predicting OC symptoms and severity. It is suggested that problems in attention may be related to the uncertainty about one's own memory as demonstrated by OCDs patients, as well as a common factor underlying comorbid ADHD and ASD symptoms.
Collapse
|
26
|
Wouters RM, Slijper HP, Esteban Lopez L, Hovius SE, Selles RW, Blomme R, Sluijter B, van der Avoort D, Kroeze A, Smit J, Debeij J, Walbeehm E, van Couwelaar G, Vermeulen G, de Schipper J, Temming J, van Uchelen J, de Boer H, de Haas K, Zöphel O, Feitz R, Souer J, Hovius S, Moojen T, Smit X, van Huis R, Pennehouat P, Schoneveld K, van Kooij Y, Wouters R, Zagt P, van Ewijk F, Moussault F, Veltkamp J, Fink A, de Ridder W, Slijper H, Selles R, Porsius J, Spekreijse K, Zhou C, Tsehaie J, Poelstra R, Janssen M, van der Oest M, Evers S, Sun P, Schrier V, Dekker J, Jansen-Landheer M, ter Stege M. Beneficial Effects of Nonsurgical Treatment for Symptomatic Thumb Carpometacarpal Instability in Clinical Practice: A Cohort Study. Arch Phys Med Rehabil 2020; 101:434-441. [DOI: 10.1016/j.apmr.2019.08.485] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/23/2019] [Accepted: 08/31/2019] [Indexed: 11/24/2022]
|
27
|
Beksinska M, Wong R, Smit J. Male and female condoms: Their key role in pregnancy and STI/HIV prevention. Best Pract Res Clin Obstet Gynaecol 2019; 66:55-67. [PMID: 32007451 DOI: 10.1016/j.bpobgyn.2019.12.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/26/2019] [Accepted: 12/02/2019] [Indexed: 01/16/2023]
Abstract
Male and female condoms are the only available Multipurpose Prevention Technologies (MPTs) that can prevent unintended pregnancy and sexually transmitted infections including HIV. If used correctly and consistently, condoms can provide levels of pregnancy protection similar to many hormonal methods. Condoms remain one of the most common methods used at first sexual intercourse and are relied on as a current use of contraception by adolescents in many regions of the world. Male and female condoms are safe and require no prescription; in particular male condoms are generally easy to access at low cost. Female condoms are more expensive than male condoms and less accessible; however, they have the advantage of being a female-initiated method. Condom users may experience some common challenges; however, recent advances in condom technology have led to new designs and modifications of existing products to improve quality and make them more attractive, acceptable and pleasurable for consumers and increase its use.
Collapse
Affiliation(s)
- Mags Beksinska
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Rachel Wong
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Jenni Smit
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
28
|
Closson K, Dietrich JJ, Beksinska M, Gibbs A, Hornschuh S, Smith T, Smit J, Gray G, Ndung’u T, Brockman M, Kaida A. Measuring sexual relationship power equity among young women and young men South Africa: Implications for gender-transformative programming. PLoS One 2019; 14:e0221554. [PMID: 31553723 PMCID: PMC6760831 DOI: 10.1371/journal.pone.0221554] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 08/11/2019] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Measures used to assess equitable relationship dynamics, including the sexual relationship power scale (SRPS) have previously been associated with lower HIV-risk among young women, and reduced perpetration of intimate partner violence among men. However, few studies describe how the SRPS has been adapted and validated for use within global youth sexual health studies. We examined gender-specific psychometric properties, reliability, and validity of a SRPS used within a South African youth-engaged cohort study. METHODS Young men and women (16-24 years) enrolled in community-based cohorts in Durban and Soweto (2014-2016) reporting a primary partner at 6-month follow-up completed a 13-item (strongly agree/agree/disagree/strongly disagree) South African adaptation of Pulerwitz's SRPS (range 13-52, higher scores indicating greater sexual relationship power [SRP] equity). SRPS modifications were made using gender-specific exploratory factor analyses (EFAs), removing items with factor loadings <0.3. Cronbach alphas were conducted for full and modified scales by gender. Using modified scales, unadjusted and adjusted regression models examined associations between 1. relevant socio-demographic and relationship determinants and SRP equity, and 2. SRP equity and sexual relationship related outcomes. All models adjusted for education, age, site, and current employment. RESULTS 235 sexually-active youth (66% women, median age = 20) were included. Mean scores across all 13 scale items were 2.71 (SD 0.30) for women and 2.70 (SD 0.4) for men. Scale Cronbach's alphas were 0.63 for women and 0.64 for men. EFAs resulted in two gender-specific single-factor SRPS. Modified SRPS Cronbach alphas increased to 0.67 for women (8-items) and 0.70 for men (9-items). After adjusting for age, site and current employment, higher education remained associated with SRP equity across genders. In adjusted models, correlates of SRP equity included primary partnerships that were age-similar (<5 years older) and <2 years in length for women and living in Soweto and younger age for men. Greater SRP equity among women was also independently associated with no recent partner violence. CONCLUSIONS Results highlight important gender differences in SRP equity measures and associations, highlighting the critically need for future research to examine gendered constructions of SRP equity in order to accurately develop, validate and use appropriate measures within quantitative surveys.
Collapse
Affiliation(s)
- Kalysha Closson
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Janan J. Dietrich
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mags Beksinska
- Maternal Adolescent and Child Health (MatCH) Research Unit (MRU), Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Andrew Gibbs
- South African Medical Research Council, Cape Town, South Africa
| | - Stefanie Hornschuh
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tricia Smith
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Jenni Smit
- Maternal Adolescent and Child Health (MatCH) Research Unit (MRU), Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Glenda Gray
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- South African Medical Research Council, Cape Town, South Africa
| | - Thumbi Ndung’u
- HIV Pathogenesis Programme and Africa Health Research Institute, University of KwaZulu-Natal, Durban, South Africa
- Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard University, Cambridge, MA United States of America
- Max Planck Institute for Infection Biology, Berlin, Germany
| | - Mark Brockman
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| |
Collapse
|
29
|
Abstract
South Africa (SA) has an integrated male and female condom (FC) programme. Since 2014, the programme has introduced two new FC brands. This study evaluated the early introduction of the availability of new FCs. Twenty-three sites participating in the National SA Female Condom Evaluation were included. Providers and clients completed interviewer-administered questionnaires assessing FC brand availability, length of distribution, how clients are informed about new FCs and reactions to the choice of more than one FC. A total of 55 providers and 51 clients were interviewed. Although all 23 sites reported they had distributed new FCs, only one had all three types available. Almost all providers (96%) thought it was important to increase choice, although some (27%) worried that having different FCs may confuse clients. Almost all clients (96%) felt it was important to increase the choice of FCs, and most women (80%) felt that using one type of FC would make it easy to use another type. Providers called for more brand-specific Information, Education and Communication (IEC) training for themselves and the community. Providers and clients seem to be very positive about the choice of FCs. Providers recommended more support in the form of IEC materials and training to assist in the provision of the expansion of FC brands.
Collapse
Affiliation(s)
- Mags Beksinska
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Bongiwe Zulu
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Phumla Nkosi
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Zonke Mabude
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jenni Smit
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
30
|
Philippar U, Lu T, Vloemans N, Bekkers M, van Nuffel L, Gaudiano M, Wnuk-Lipinska K, Van Der Leede B, Amssoms K, Kimpe K, Medaer B, Greway T, Abraham Y, Cummings M, Trella E, Vanhoof G, Sun W, Thuring J, Connolly P, Linders J, Gerecitano J, Goldberg J, Edwards J, Elsayed Y, Smit J, Bussolari J, Attar R. DISCOVERY OF A NOVEL, POTENTIAL FIRST-IN-CLASS MALT1 PROTEASE INHIBITOR FOR THE TREATMENT OF B CELL LYMPHOMAS. Hematol Oncol 2019. [DOI: 10.1002/hon.88_2629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- U. Philippar
- Oncology Discovery; Janssen Research & Development; Beerse Belgium
| | - T. Lu
- Discovery Chemistry; Janssen R&D; Springhouse United States
| | - N. Vloemans
- Oncology Discovery; Janssen Research & Development; Beerse Belgium
| | - M. Bekkers
- Oncology Discovery; Janssen Research & Development; Beerse Belgium
| | - L. van Nuffel
- Oncology Discovery; Janssen Research & Development; Beerse Belgium
| | - M. Gaudiano
- Oncology Discovery; Janssen Research & Development; Beerse Belgium
| | - K. Wnuk-Lipinska
- Oncology Discovery; Janssen Research & Development; Beerse Belgium
| | | | | | - K. Kimpe
- Pharmaceutical Sciences; Janssen R&D; Beerse Belgium
| | - B. Medaer
- Portfolio Management; Janssen R&D; Beerse Belgium
| | - T. Greway
- DMPK; Janssen R&D; Raritan United States
| | - Y. Abraham
- Computational Biology; Janssen R&D; Beerse Belgium
| | - M. Cummings
- Computational Chemistry; Janssen R&D; Springhouse United States
| | - E. Trella
- Molecular and Cellular Pharmacology; Janssen R&D; Beerse Belgium
| | - G. Vanhoof
- Molecular and Cellular Pharmacology; Janssen R&D; Beerse Belgium
| | - W. Sun
- Molecular and Cellular Pharmacology; Janssen R&D; Springhouse United States
| | - J. Thuring
- Discovery Chemistry; Janssen R&D; Beerse Belgium
| | - P. Connolly
- Discovery Chemistry; Janssen R&D; Springhouse United States
| | - J. Linders
- Project Management; Janssen R&D; Beerse Belgium
| | - J. Gerecitano
- Experimental Medicine; Janssen R&D; Raritan United States
| | - J. Goldberg
- Experimental Medicine; Janssen R&D; Raritan United States
| | - J.P. Edwards
- Discovery Chemistry; Janssen R&D; Springhouse United States
| | - Y. Elsayed
- Oncology Heme DAS; Janssen R&D; Springhouse United States
| | - J. Smit
- CDTL Oncology; Janssen R&D; Springhouse United States
| | - J. Bussolari
- CDTL Oncology; Janssen R&D; Springhouse United States
| | - R. Attar
- Oncology Heme DAS; Janssen R&D; Springhouse United States
| |
Collapse
|
31
|
Milford C, Greener LR, Beksinska M, Greener R, Mabude Z, Smit J. Provider understandings of and attitudes towards integration: Implementing an HIV and sexual and reproductive health service integration model, South Africa. Afr J AIDS Res 2019; 17:183-192. [PMID: 30003849 DOI: 10.2989/16085906.2018.1478314] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In South Africa, a lack of integration between sexual and reproductive health (SRH) and HIV services has led to lost opportunities in the treatment cascade. In a context of high HIV, tuberculosis (TB) and unplanned pregnancies, a model for integrating SRH and HIV services was implemented in a hospital and six feeder clinics in KwaZulu-Natal, South Africa. Changes in healthcare provider knowledge, attitudes and understandings were explored following model implementation. Baseline data were collected via focus group discussions (FGDs) and a cross-sectional survey, and were used to inform the development of a model for integrating SRH and HIV services. Following the implementation of the model, an endline survey was conducted to explore any changes. Four FGDs were conducted with healthcare providers at study facilities. A total of 46 providers participated in the baseline survey, and 44 in the endline survey. Qualitative data were thematically analysed using NVivo 11, and quantitative data were descriptively analysed using SPSS 24. The understanding of integration improved by endline. Integration of services was considered important for reducing stigma and increasing access to and improving quality of care. Concerns raised were that integration would increase workload and time per client. Physical structure of facilities was not always conducive to referral or integration. Perceived benefits of integration and actual integration of services improved between baseline and endline. Enhanced understanding of integration and increased levels of reported integration over time imply that providers are more aware, suggesting that the model was effective. Provider perspectives and understandings are important for the successful integration of services. This integration model is relevant and useful to inform training and mentoring of providers, as well as to provide recommendations for policy implementation.
Collapse
Affiliation(s)
- Cecilia Milford
- a MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences , University of the Witwatersrand , Durban , South Africa
| | - Letitia Rambally Greener
- a MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences , University of the Witwatersrand , Durban , South Africa
| | - Mags Beksinska
- a MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences , University of the Witwatersrand , Durban , South Africa
| | - Ross Greener
- a MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences , University of the Witwatersrand , Durban , South Africa
| | - Zonke Mabude
- a MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences , University of the Witwatersrand , Durban , South Africa
| | - Jenni Smit
- a MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences , University of the Witwatersrand , Durban , South Africa
| |
Collapse
|
32
|
Beksinska M, Greener R, Mphili N, Smit J, Kilbourne-Brook M, Coffey PS. Functional performance study of an adapted design of the woman's condom: a crossover, noninferiority, randomized clinical trial. EUR J CONTRACEP REPR 2019; 24:233-239. [PMID: 31112062 DOI: 10.1080/13625187.2019.1610940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: We aimed to assess the functional performance and safety of a modified Woman's Condom (WC2) against the existing FC2 female condom. Study design: This randomized clinical trial enrolled 287 women in one South African site. The primary outcome of the study was the rate of female condom failure. Participants were asked to use five of each female condom type and to collect information on use in a condom log at home and were interviewed after use of each FC type. Results: Noninferiority was demonstrated for the WC2 with respect to the reference condom FC2 for all condom functions. The WC2 was found to be superior to the FC2 reference condom for clinical failure (p = .000), total female condom failure (p = .001), misdirection (p = .000) and slippage (p = .004). Conclusion: The WC2 female condom performs as well as the FC2 female condom and offers good stability during use. Implications: Results from this study will inform further refinement of this female condom design, resulting in a new and potentially less expensive Woman's Condom.
Collapse
Affiliation(s)
- Mags Beksinska
- a MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences , University of the Witwatersrand , Durban , South Africa
| | - Ross Greener
- a MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences , University of the Witwatersrand , Durban , South Africa
| | - Nonhlanhla Mphili
- a MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences , University of the Witwatersrand , Durban , South Africa
| | - Jenni Smit
- a MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences , University of the Witwatersrand , Durban , South Africa
| | | | | |
Collapse
|
33
|
Montgomery ET, Beksinska M, Mgodi N, Schwartz J, Weinrib R, Browne EN, Mphili N, Musara P, Jaggernath M, Ju S, Smit J, Chirenje ZM, Doncel GF, van der Straten A. End-user preference for and choice of four vaginally delivered HIV prevention methods among young women in South Africa and Zimbabwe: the Quatro Clinical Crossover Study. J Int AIDS Soc 2019; 22:e25283. [PMID: 31069957 PMCID: PMC6506690 DOI: 10.1002/jia2.25283] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 04/05/2019] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Adherence to HIV prevention methods is a challenge, particularly for young women in Sub-Saharan Africa. End-user research during product development can inform modifiable factors to increase future uptake and adherence. METHODS Preferences for four vaginally inserted placebo HIV prevention methods were assessed among Zimbabwean and South African young women using a crossover clinical design. For each of months 1 to 4, participants were asked to use a pre-coitally inserted film, insert (vaginal tablet) and gel once/week for a month, and a monthly ring in a randomly assigned sequence. Participants subsequently chose one preferred product to use as directed for the final study month. Women ranked the four products from most preferred to least preferred at enrolment and after trying all products. RESULTS A total of 200 women aged 18 to 30 (mean 23) were enrolled; 178 (89%) completed follow-up. At baseline, 41% of participants selected the gel as their most preferred product and 61% selected the ring as least preferred. During the crossover period, most (82% to 85%) self-reported using each product at least once a week, although only half the time with sex. Objective biomarker data confirmed adequate use of all products. After trying each product, rankings changed with the film, ring, insert and gel being selected by 29%, 28%, 26% and 16% respectively. Choice varied significantly by country (p < 0.001): More Zimbabweans chose the film (45%), and more South Africans chose the insert (34%). Among women choosing the ring, 88% reported using it every time with sex. By contrast, self-reported adherence was lower for "on-demand" (coitally associated) products, with 40% to 55% using them every time during sex (p < 0.001). CONCLUSIONS Preferences for these four dosage forms varied before and after use, and both within and across countries - there was no clear favourite - indicating the need for a range of options for end-users The ring's popularity increased the most with use, was the second most preferred delivery system, and per self-report, provided more coverage during sex. These end-user perspectives provide important information to product developers and funding agencies.
Collapse
Affiliation(s)
| | - Mags Beksinska
- MRU (MatCH Research Unit)Faculty of Health SciencesUniversity of the WitwatersrandDurbanSouth Africa
| | - Nyaradzo Mgodi
- University of Zimbabwe College of Health Sciences Clinical Trials Research CentreHarareZimbabwe
| | | | - Rachel Weinrib
- Women's Global Health ImperativeRTI InternationalSan FranciscoCAUSA
| | - Erica N Browne
- Women's Global Health ImperativeRTI InternationalSan FranciscoCAUSA
| | - Nonhlanhla Mphili
- MRU (MatCH Research Unit)Faculty of Health SciencesUniversity of the WitwatersrandDurbanSouth Africa
| | - Petina Musara
- University of Zimbabwe College of Health Sciences Clinical Trials Research CentreHarareZimbabwe
| | - Manjeetha Jaggernath
- MRU (MatCH Research Unit)Faculty of Health SciencesUniversity of the WitwatersrandDurbanSouth Africa
| | - Susan Ju
- CONRADEastern Virginia Medical SchoolArlingtonVAUSA
| | - Jenni Smit
- MRU (MatCH Research Unit)Faculty of Health SciencesUniversity of the WitwatersrandDurbanSouth Africa
| | - Z Mike Chirenje
- University of Zimbabwe College of Health Sciences Clinical Trials Research CentreHarareZimbabwe
| | | | - Ariane van der Straten
- Women's Global Health ImperativeRTI InternationalSan FranciscoCAUSA
- Center for AIDS Prevention StudiesDepartment of MedicineUniversity of CaliforniaSan FranciscoCAUSA
| |
Collapse
|
34
|
Davies NECG, Ashford G, Bekker LG, Chandiwana N, Cooper D, Dyer SJ, Jankelowitz L, Mhlongo O, Mnyani CN, Mulaudzi MB, Moorhouse M, Myer L, Patel M, Pleaner M, Ramos T, Rees H, Schwartz S, Smit J, van Zyl DS. Guidelines to support HIV-affected individuals and couples to achieve pregnancy safely: Update 2018. South Afr J HIV Med 2018; 19:915. [PMID: 30473876 PMCID: PMC6244351 DOI: 10.4102/sajhivmed.v19i1.915] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 09/20/2018] [Indexed: 11/23/2022] Open
Affiliation(s)
- Natasha E C G Davies
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | | | - Linda-Gail Bekker
- The Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa.,Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
| | - Nomathemba Chandiwana
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Diane Cooper
- School of Public Health, University of Western Cape, South Africa
| | - Silker J Dyer
- Department of Obstetrics and Gynaecology, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, South Africa
| | | | - Otty Mhlongo
- KwaZulu-Natal Department of Health, South Africa
| | - Coceka N Mnyani
- Department of Obstetrics and Gynaecology, School of Clinical Medicine, University of the Witwatersrand, South Africa
| | | | - Michelle Moorhouse
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Landon Myer
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Malika Patel
- Department of Obstetrics and Gynaecology, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, South Africa
| | - Melanie Pleaner
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Tatiana Ramos
- Southern African HIV Clinicians' Society, South Africa
| | - Helen Rees
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Sheree Schwartz
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, South Africa.,Department of Epidemiology, Johns Hopkins School of Public Health, United States
| | - Jenni Smit
- Department of Obstetrics and Gynaecology, School of Clinical Medicine, University of the Witwatersrand, South Africa
| | | |
Collapse
|
35
|
Pieters R, Bol-Schoenmakers M, Weaver R, Smit J, Giustarini G. Neutrophil-monocyte interplay in drug-induced liver injury. Toxicol Lett 2018. [DOI: 10.1016/j.toxlet.2018.06.1181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
36
|
Lewinsohn R, Crankshaw T, Tomlinson M, Gibbs A, Butler L, Smit J. “This baby came up and then he said, “I give up!”: The interplay between unintended pregnancy, sexual partnership dynamics and social support and the impact on women's well-being in KwaZulu-Natal, South Africa. Midwifery 2018; 62:29-35. [DOI: 10.1016/j.midw.2018.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 01/02/2018] [Accepted: 03/04/2018] [Indexed: 12/16/2022]
|
37
|
Beksinska M, Greener R, Smit J, Maphumulo B, Mphili N, Kilbourne-Brook M, Coffey PS. A Randomized Crossover Study Evaluating the Use and Acceptability of the SILCS Diaphragm Compared to Vaginal Applicators for Vaginal Gel Delivery. AIDS Behav 2018; 22:127-132. [PMID: 28993940 DOI: 10.1007/s10461-017-1913-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION This study aimed to assess acceptability and preferences for the SILCS diaphragm for vaginal gel delivery compared to a prefilled applicator. METHODS A randomized crossover study among 115 women in South Africa, using both methods during five sex acts. RESULTS We found no significant differences in acceptability between the two products. Experience of gel leakage after sex was greater when inserted via applicator. More women were interested in SILCS/gel for multipurpose protection (68%) than in either SILCS alone (17%) or microbicide gel alone (14%). CONCLUSIONS A SILCS gel delivery system for multipurpose prevention seems feasible and acceptable.
Collapse
|
38
|
Thomas S, Kuiper B, Hu J, Smit J, Liao Z, Zhong Z, Rijnders G, Vailionis A, Wu R, Koster G, Xia J. Localized Control of Curie Temperature in Perovskite Oxide Film by Capping-Layer-Induced Octahedral Distortion. Phys Rev Lett 2017; 119:177203. [PMID: 29219472 DOI: 10.1103/physrevlett.119.177203] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Indexed: 06/07/2023]
Abstract
With reduced dimensionality, it is often easier to modify the properties of ultrathin films than their bulk counterparts. Strain engineering, usually achieved by choosing appropriate substrates, has been proven effective in controlling the properties of perovskite oxide films. An emerging alternative route for developing new multifunctional perovskite is by modification of the oxygen octahedral structure. Here we report the control of structural oxygen octahedral rotation in ultrathin perovskite SrRuO_{3} films by the deposition of a SrTiO_{3} capping layer, which can be lithographically patterned to achieve local control. Using a scanning Sagnac magnetic microscope, we show an increase in the Curie temperature of SrRuO_{3} due to the suppression octahedral rotations revealed by the synchrotron x-ray diffraction. This capping-layer-based technique may open new possibilities for developing functional oxide materials.
Collapse
Affiliation(s)
- S Thomas
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697, USA
| | - B Kuiper
- MESA+ Institute for Nanotechnology, University of Twente, 7500AE Enschede, Netherlands
| | - J Hu
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697, USA
- College of Physics, Optoelectronics and Energy, Soochow University, Suzhou, Jiangsu 215006, China
| | - J Smit
- Geballe Laboratory for Advanced Materials, Stanford University, Stanford, California 94305, USA
| | - Z Liao
- MESA+ Institute for Nanotechnology, University of Twente, 7500AE Enschede, Netherlands
| | - Z Zhong
- Key Laboratory of Magnetic Materials and Devices & Zhejiang Province Key Laboratory of Magnetic Materials and Application Technology, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201, China
| | - G Rijnders
- MESA+ Institute for Nanotechnology, University of Twente, 7500AE Enschede, Netherlands
| | - A Vailionis
- Geballe Laboratory for Advanced Materials, Stanford University, Stanford, California 94305, USA
| | - R Wu
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697, USA
| | - G Koster
- MESA+ Institute for Nanotechnology, University of Twente, 7500AE Enschede, Netherlands
| | - J Xia
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697, USA
| |
Collapse
|
39
|
Kastner J, Milford C, Akatukwasa C, Kembabazi A, Smit J. Implementing a Global Health Qualitative Research Study: Experiences of a Project Coordinator in Uganda. East Afr Health Res J 2017. [DOI: 10.24248/eahrj.v1i2.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
40
|
Kastner J, Milford C, Akatukwasa C, Kembabazi A, Smit J. Implementing a Global Health Qualitative Research Study: Experiences of a Project Coordinator in Uganda. East Afr Health Res J 2017; 1:113-122. [PMID: 34308165 PMCID: PMC8279193 DOI: 10.24248/eahrj-d-16-00343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 07/20/2017] [Indexed: 11/20/2022] Open
Abstract
Qualitative research in global health requires substantial operational and logistical support during both the implementation phase and day-to-day operations. However, little to no published work shares the experiences of international qualitative research teams. Yet, without a strong project foundation and attention to everyday details, studies can begin without appropriate guidance and, as a result, poor quality data may be generated. This paper presents a detailed account of a project coordinator's experience implementing 4 qualitative HIV and reproductive health studies in Uganda between 2012 and 2014, reflecting on our research team's practices and lessons learnt, and provides recommendations for successful project implementation. The aim of this paper is to help new global health qualitative project coordinators, and international teams more generally, by detailing 6 coordination tasks: hiring, training, team communication, organization of study documents, data collection and storage, and research ethics. To avoid repeat learning of basic, yet important, logistical steps by each new qualitative research project coordinator, this paper can help coordinators think about how to organize their work in order to prepare for both planned and unplanned challenges that have been encountered by others. Sharing operational and logistical experiences and expertise can benefit the global health community and help future studies run more efficiently.
Collapse
Affiliation(s)
- Jasmine Kastner
- McGill University Health Centre, Research Institute, Montreal, Canada
| | - Cecilia Milford
- University of the Witwatersrand, Faculty of Health Sciences, Durban, South Africa
| | | | - Annet Kembabazi
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Jenni Smit
- University of the Witwatersrand, Faculty of Health Sciences, Durban, South Africa
| |
Collapse
|
41
|
van Vlijmen B, van Gool L, Repping-Wuts H, Ketels T, Kerstens M, Burger D, Hermus A, Smit J. [Successful switch from originator to biosimilar growth hormone: patients' experiences]. Ned Tijdschr Geneeskd 2017; 161:D1415. [PMID: 29098966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To survey patients' experiences with the switch from an originator biologic to a biosimilar growth hormone. DESIGN Questionnaire. METHOD We developed a questionnaire in which patients were asked about their experiences with the switch from an originator biologic to a biosimilar growth hormone. The questionnaire was distributed to all 207 patients who were switched to the biosimilar in the Radboudumc since April 2014. The following topics were covered: (a) difficulties experienced in switching from originator to biosimilar; (b) patient education; (c) effectiveness of the biosimilar product; (d) possible adverse effects experienced; and (e) experience with application of the new injection system for the biosimilar. RESULTS The questionnaire was completed by 79 patients (38.1%). Seventy-two percent of the patients indicated that before switching they had no concerns about switching. The other patients did have concerns beforehand, which were related to the different injection system (n=13), possible new adverse effects (n=13) and safety of the biosimilar (n=11). Before the switch was made, all patients had been informed in writing and also individually by endocrinologists and specialised nurses; 93% of the patients was satisfied with the counselling provided by Radboudumc. Concerning use of the new injection system, 95% of the patients indicated that they had received individual training and 98% was confident in using it. Patients rated the process of transition to the biosimilar at the Radboudumc an average of 7.8 (range: 1-10). CONCLUSION Patients were satisfied with the switch to the biosimilar growth hormone and there were few side-effects. Some minor problems were encountered, but these could be solved. Extensive counselling of patients before switching to prescription of biosimilars proved to be worthwhile. The switch has led to a significant reduction in costs.
Collapse
|
42
|
Brose M, Jarzab B, Elisei R, Giannetta L, Bastholt L, Fouchardiere C, Pacini F, Paschke R, Nutting C, Shong Y, Sherman S, Smit J, Chung J, Meinhardt G, Schlumberger M, Kappeler C. Final overall survival analysis of patients with locally advanced or metastatic radioactive iodine-refractory differentiated thyroid cancer (RAI-rDTC) treated with sorafenib in the phase 3 DECISION trial: An exploratory crossover adjustment analyses. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw376.06] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
43
|
Mukudu H, Martinson N, Sartorius B, Coetzee J, Dietrich J, Mokgatswana K, Jewkes R, Gray GE, Dugas M, Béhanzin L, Guédou FA, Gagnon MP, Alary M, Rutakumwa R, Mbonye M, Kiwanuka T, Nakamanya S, Muhumuza R, Nalukenge W, Seeley J, Atujuna M, Wallace M, Brown B, Bekker LG, Newman PA, Harryparsad R, Olivier AJ, Jaspan HB, Wilson D, Dietrich J, Martinson N, Mukudu H, Mkhize N, Morris L, Cianci G, Dinh M, Hope T, Passmore JAS, Gray CM, Henrick BM, Yao XD, Rosenthal KL, Henrick BM, Yao XD, Drannik AG, Abimiku A, Rosenthal KL, Chanzu N, Mwanda W, Oyugi J, Anzala O, Mbow M, Jallow S, Thiam M, Davis A, Diouf A, Ndour CT, Seydi M, Dieye TN, Mboup S, Goodier M, Rilley E, Jaye A, Yao XD, Omange RW, Henrick BM, Lester RT, Kimani J, Ball TB, Plummer FA, Rosenthal KL, Béhanzin L, Guédou FA, Geraldo N, Mastétsé EG, Sossa JC, Zannou MD, Alary M, Osawe S, Okpokoro E, Okolo F, Umaru S, Abimiku R, Audu S, Datong P, Abimiku A, Nyange J, Olenja J, Mutua G, Jaoko W, Omosa-Manyonyi G, Farah B, Khaniri M, Anzala O, Cockcroft A, Tonkin K, Girish I, Mhati P, Cunningham A, Andersson N, Farah B, Indangasi J, Jaoko W, Mutua G, Khaniri M, Nyange J, Anzala O, Diphoko T, Gaseitsiwe S, Maiswe V, Iketleng T, Maruapula D, Bedi K, Moyo S, Musonda R, Wainberg M, Makhema J, Novitsky V, Marlink R, Essex M, Okoboi S, Ssali L, Kalibala S, Birungi J, Egessa A, Wangisi J, Okullu LJ, Bakanda C, Obare F, Boer IMSD, Semvua HH, van den Boogaard J, Kiwango KW, Ngowi KM, Nieuwkerk PT, Aarnoutse RE, Kiwelu I, Muro E, Kibiki GS, Datiri R, Choji G, Osawe S, Okpokoro E, Okolo F, Umaru S, Abimiku R, Audu S, Datong P, Abimiku A, Fomsgaard A, Karlsson I, Jensen KJ, Jensen SS, Leo-Hansen C, Jespersen S, Da Silva Té D, Rodrigues CM, da Silva ZJ, Janitzek CM, Gerstoft J, Kronborg G, Okpokoro E, Osawe S, Daitiri R, Choji G, Umaru S, Okolo F, Datong P, Abimiku A, Emily N, Joyce O, Robert LR, Anzala A, Viljoen K, Wendoh J, Kidzeru E, Karaoz U, Brodie E, Botha G, Mulder N, Gray C, Cameron W, Stintzi A, Jaspan H, Levett PN, Alexander D, Gulzar N, Grewal PS, Poon AFY, Brumme Z, Harrigan PR, Brooks JI, Sandstrom PA, Calvez S, Sanche SE, Scott JK, Swartz L, Kagee A, Lesch A, Kafaar Z, De Wet A, Okpokoro E, Osawe S, Daitiri R, Choji G, Umaru S, Okolo F, Datong P, Abimiku A, Dietrich J, Smith T, Cotton L, Hornschuh S, van der Watt M, Miller CL, Gray G, Smit J, Jaggernath M, Ndung’u T, Brockman M, Kaida A, Akolo M, Kimani J, Gelmon L, Chitwa M, Osero J, Cockcroft A, Marokoane N, Kgakole L, Maswabi B, Mpofu N, Ansari U, Andersson N, Nakinobe E, Miiro GM, Zalwango F, Nakiyingi-Miiro J, Kaleebu P, Semwanga JR, Nyanzi E, Musoke SN, Nakinobe E, Miiro G, Mbidde EK, Lutalo T, Kaleebu P, Handema R, Chianzu GP, Thiam M, Diagne-Gueye D, Ndiaye MK, Mbow M, Ndiaye BP, Traore I, Dia MC, Thomas G, Tour-Kane C, Mboup S, Jaye A, Nyanzi E, Mbidde EK, Kaleebu P, Mpendo J, Kimani J, Birungi J, Muyindike W, Kambugu A, Sebastian H, Ray H, Mike C, Bertin KJ, Modest M, Thiam M, Janha O, Davis A, Amambua-Ngwa A, Nwakanma DC, Mboup S, Jaye A, Jespersen S, Hønge BL, Esbjörnsson J, Medina C, Da Silva TÉ D, Correira FG, Laursen AL, Østergaard L, Andersen A, Aaby P, Erikstrup C, Wejse C, Dieye S, Sarr M, Sy H, Mbodj HD, Ndiaye M, Ndiaye A, Moussa S, Jaye A, Mboup S, Nyombi BM, Shao ER, Chilumba IB, Moyo S, Gaseitsiwe S, Musonda R, Datong P, Inyang B, Osawe S, Izang A, Cole C, Okolo F, Cameron B, Rosenthal K, Gray C, Jaspan H, Abimiku A, Seraise B, Andrea-Marobela K, Moyo S, Musonda R, Makhema J, Essex M, Gaseitsiwe S. Afri-Can Forum 2. BMC Infect Dis 2016; 16 Suppl 2:315. [PMID: 27410689 PMCID: PMC4943497 DOI: 10.1186/s12879-016-1466-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
A1 Introduction to the 2nd synchronicity forum of GHRI/CHVI-funded Canadian and African HIV prevention and vaccine teams O1 Voluntary medical male circumcision for prevention of heterosexual transmission of HIV in adult males in Soweto: What do indicators and incidence rate show? Hillary Mukudu, Neil Martinson, Benn Sartorius O2 Developing a peer-led community mobilization program for sex workers in Soweto: HIV risk and demographics Jenny Coetzee, Janan Dietrich, Kgaugelo Mokgatswana, Rachel Jewkes, Glenda E. Gray O3 Salient beliefs about adherence: A qualitative survey conducted as part of the demonstration study on "treatment as prevention" (TasP) and "pre-exposure prophylaxis" (PrEP) among female sex workers (FSWS) in Cotonou, Benin Marylène Dugas, Luc Béhanzin, Fernand A. Guédou, Marie-Pierre Gagnon, Michel Alary O4 Relative perception of risk as a driver of unsafe sexual practices among key populations: Cases of fisherfolk and women and their partners involved in multiple sexual partnerships in Uganda Rwamahe Rutakumwa, Martin Mbonye, Thadeus Kiwanuka, Sarah Nakamanya, Richard Muhumuza, Winfred Nalukenge, Janet Seeley O5 Exploring the acceptability of new biomedical HIV prevention technologies among MSM, adolescents and heterosexual adults in South Africa Millicent Atujuna, Melissa Wallace, Ben Brown, Linda Gail Bekker, Peter A. Newman O6 HIV-susceptible target cells in foreskins after voluntary medical male circumcision in South Africa Rushil Harryparsad, Abraham J. Olivier, Heather B. Jaspan, Douglas Wilson, Janan Dietrich, Neil Martinson, Hillary Mukudu, Nonhlanhla Mkhize, Lynn Morris, Gianguido Cianci, Minh Dinh, Thomas Hope, Jo-Ann S. Passmore, Clive M. Gray O7 HIV-1 proteins activate innate immune responses via TLR2 heterodimers Bethany M. Henrick, Xiao-Dan Yao, Kenneth L. Rosenthal, the INFANT Study Team O8 Characterization of an innate factor in human milk and mechanisms of action against HIV-1 Bethany M. Henrick, Xiao-Dan Yao, Anna G. Drannik, Alash’le Abimiku, Kenneth L. Rosenthal, the INFANT Study Team O9 Secretor status and susceptibility to HIV infections among female sex workers in Nairobi, Kenya Nadia Chanzu, Walter Mwanda, Julius Oyugi, Omu Anzala O10 Natural Killer cell recall responsiveness to Gag-HIV-1 peptides of HIV-1 exposed but uninfected subjects are associated with peripheral CXCR6+ NK cell subsets Moustapha Mbow, Sabelle Jallow, Moussa Thiam, Alberta Davis, Assane Diouf, Cheikh T. Ndour, Moussa Seydi, Tandakha N. Dieye, Souleymane Mboup, Martin Goodier, Eleanor Rilley, Assan Jaye O11 Profiles of resistance: Local innate mucosal immunity to HIV-1 in commercial sex workers Xiao-Dan Yao, RW. Omange, Bethany M. Henrick, Richard T. Lester, Joshua Kimani, T. Blake Ball, Francis A. Plummer, Kenneth L. Rosenthal O12 Early antiretroviral therapy and pre-exposure prophylaxis for HIV prevention among female sex workers in Cotonou, Benin: A demonstration project Luc Béhanzin, Fernand A. Guédou, Nassirou Geraldo, Ella Goma Mastétsé, Jerôme Charles Sossa, Marcel Djimon Zannou, Michel Alary O13 Building capacity for HIV prevention trials: Preliminary data from a Nigerian cohort of HIV exposed sero-negatives (HESN) Sophia Osawe, Evaezi Okpokoro, Felicia Okolo, Stephen Umaru, Rebecca Abimiku, Sam Audu, Pam Datong, Alash’le Abimiku O14 Equipping healthcare professionals with skills required for the conduct of clinical trials in an effort to build capacity. Lessons learned Jacquelyn Nyange, Joyce Olenja, Gaudensia Mutua, Walter Jaoko, Gloria Omosa-Manyonyi, Bashir Farah, Maureen Khaniri, Omu Anzala O15 Educational technology to support active learning for HIV researchers and planners Anne Cockcroft, Kendra Tonkin, Indu Girish, Puna Mhati, Ashley Cunningham, Neil Andersson O16 From Lake Kivu (Rwanda) and Lake Malawi (Tanzania) to the shores of Lake Victoria (Uganda): Strengthening laboratory capacity through Good Clinical Laboratory Practice training Bashir Farah, Jackton Indangasi, Walter Jaoko, Gaudensia Mutua, Maureen Khaniri, Jacquelyn Nyange, Omu Anzala O17 Rilpivirine and etravirine resistance mutations in HIV-1 subtype C infected patients on a non-nucleoside reverse transcriptase inhibitor-based combination antiretroviral therapy in Botswana Thabo Diphoko, Simani Gaseitsiwe, Victoria Maiswe, Thato Iketleng, Dorcas Maruapula, Keabetswe Bedi, Sikhulile Moyo, Rosemary Musonda, Mark Wainberg, Joseph Makhema, Vladimir Novitsky, Richard Marlink, Max Essex O18 From home-based HIV testing to initiation of treatment: The AIDS Support Organization (TASO) Experience with Home-based HIV Counselling and Testing (HBHCT) among Adolescents in Uganda, 2005-2011 Stephen Okoboi, Livingstone Ssali, Sam Kalibala, Josephine Birungi, Aggrey Egessa, Jonathan Wangisi, Lyavala Joanne Okullu, Celestin Bakanda, Francis Obare41 O19 Feasibility study on using real time medication monitoring among HIV infected and Tuberculosis patients in Kilimanjaro, Tanzania I. Marion Sumari-de Boer, Hadija H. Semvua, Jossy van den Boogaard, Krisanta W. Kiwango, Kennedy M. Ngowi, Pythia T. Nieuwkerk, Rob E. Aarnoutse, Ireen Kiwelu, Eva Muro, Gibson S. Kibiki O20 Deaths still among sero-discordant cohort in Nigeria despite Access to treatment Ruth Datiri, Grace Choji, Sophia Osawe, Evaezi Okpokoro, Felicia Okolo, Stephen Umaru, Rebecca Abimiku, Samuel Audu, Pam Datong, Alash’le Abimiku O21 Therapeutic HIV-1 vaccine trials in Denmark and Guinea-Bissau Fomsgaard A, Karlsson I, Jensen KJ, Jensen SS, Leo-Hansen C, Jespersen S, Da Silva Té D, Rodrigues CM, da Silva ZJ, Janitzek CM, Gerstoft J, Kronborg G, the WAPHIR Group O22 Willingness to participate in a HIV vaccine Trial among HIV exposed sero-negative (HESN) persons in Jos, Nigeria Evaezi Okpokoro, Sophia Osawe, Ruth Daitiri, Grace Choji, Stephen Umaru, Felicia Okolo, Pam Datong, Alash'le Abimiku O23 Clinical research volunteers’ perceptions and experiences of screening for enrolment at KAVI-Institute of Clinical Research, Kenya Nyariki Emily, Olenja Joyce, Lorway R. Robert, Anzala Anzala O24 Gut microbiome, HIV-exposure, and vaccine responses in South African infants Katie Viljoen, Jerome Wendoh, Elvis Kidzeru, Ulas Karaoz, Eoin Brodie, Gerrit Botha, Nicola Mulder, Clive Gray, William Cameron, Alain Stintzi, Heather Jaspan, for the INFANT study team O25 Analysis of HIV pol diversity in the concentrated HIV epidemic in Saskatchewan Paul N. Levett, David Alexander, Naveed Gulzar, Prabvir S. Grewal, Art F. Y. Poon, Zabrina Brumme, P. Richard Harrigan, James I. Brooks, Paul A. Sandstrom, Stryker Calvez, Stephen E. Sanche, Jamie K. Scott P1 Evaluating a HIV vaccine research community engagement programme at two HIV prevention research centres in the Western Cape Leslie Swartz, Ashraf Kagee, Anthea Lesch, Zuhayr Kafaar, Anneliese De Wet P2 Validating HIV acquisition risk score using a cohort HIV exposed sero-negative persons in a discordant relationship in Jos, Nigeria, West Africa Evaezi Okpokoro, Sophia Osawe, Ruth Daitiri, Grace Choji, Stephen Umaru, Felicia Okolo, Pam Datong, Alash'le Abimiku P3 Bridging the gap between adults and adolescents and youth adults (AYA) – Employing a youth-centred approach to investigate HIV risk among AYA in Soweto and Durban, South Africa Janan Dietrich, Tricia Smith, Laura Cotton, Stefanie Hornschuh, Martin van der Watt, Cari L. Miller, Glenda Gray, Jenni Smit, Manjeetha Jaggernath, Thumbi Ndung’u, Mark Brockman, Angela Kaida, on behalf of the AYAZAZI study teams P4 Neighbours to sex workers: A key population that has been ignored Maureen Akolo, Joshua Kimani, Prof Larry Gelmon, Michael Chitwa, Justus Osero P5 Young women’s access to structural support programmes in a district of Botswana Anne Cockcroft, Nobantu Marokoane, Leagajang Kgakole, Boikhutso Maswabi, Neo Mpofu, Umaira Ansari, Neil Andersson P6 Voices for action from peri-urban Ugandan students, teachers and parents on HIV/STI prevention: Qualitative research results Nakinobe Elizabeth, Miiro George Mukalazi, Zalwango Flavia, Nakiyingi-Miiro Jessica, Kaleebu Potiano P7 Engaging Social Media as an education tool on the fly: The use of Facebook for HIV and Ebola prevention and awareness amongst adolescents in Uganda John Ross Semwanga, Emily Nyanzi, Saidat Namuli Musoke, Elizabeth Nakinobe, George Miiro, Edward Katongole Mbidde, Tom Lutalo, Pontiano Kaleebu P8 Circulating HIV-1 subtypes among sexual minority populations in Zambia Ray Handema, Graham P. Chianzu P9 The Development of HIV Bio-bank resource management to support clinical trial and Intervention research: WAPHIR experience Moussa Thiam, Diabou Diagne-Gueye, Mame K. Ndiaye, Moustapha Mbow, Birahim P. Ndiaye, Ibrahima Traore, Mamadou C. Dia, Gilleh Thomas, Coumba Tour-Kane, Souleymane Mboup, Assan Jaye P10 Capacity building for clinical trials as a novel approach for scaling up HIV prevention research initiatives in East Africa: achievements and challenges Emily Nyanzi, Edward Katongole Mbidde, Pontiano Kaleebu, Juliet Mpendo, Joshua Kimani, Josephine Birungi, Winnie Muyindike, Andrew Kambugu P11 Community and media perspective of research; an advocacy workshop on HIV prevention research Hachizovu Sebastian, Handema Ray, Chaponda Mike, Kabuya Jean Bertin, Mulenga Modest P12 Development of a quantitative HIV-1 and HIV-2 real time PCR (qRT-PCR) viral load assay Moussa Thiam, Omar Janha, Alberta Davis, Alfred Amambua-Ngwa, Davis C. Nwakanma, Souleymane Mboup, Assan Jaye P13 Differential effects of sex in a West African Cohort of HIV-1, HIV-2 and HIV-1/2 dual infected patients: Men are worse off Sanne Jespersen, Bo Langhoff Hønge, Joakim Esbjörnsson, Candida Medina, David Da Silva TÉ, Faustino Gomes Correira, Alex Lund Laursen, Lars Østergaard, Andreas Andersen, Peter Aaby, Christian Erikstrup, Christian Wejse, for the Bissau HIV Cohort study group P14 HIV-infected adolescents in transition from pediatric to adult HIV care in Dakar, Senegal: sample characteristics and immunological and virological profiles Siry Dieye, Moussa Sarr, Haby Sy, Helene D Mbodj, Marianne Ndiaye, Amy Ndiaye, Seydi Moussa, Assan Jaye, Souleymane Mboup100 P15 Molecular characterization of vertically transmitted HIV-1 among children born to HIV-1 seropositive mothers in Northern Tanzania Balthazar M. Nyombi, Elichilia R. Shao, Innocent B. Chilumba, Sikhulile Moyo, Simani Gaseitsiwe, Rosemary Musonda P16 Breast-fed HIV-1 exposed infants play catch up. A preliminary report Pam Datong, Bucky Inyang, Sophia Osawe, Abel Izang, Chundung Cole, Felicia Okolo, Bill Cameron, Kenneth Rosenthal, Clive Gray, Heather Jaspan, Alash’le Abimiku, the INFANT study team P17 The frequency of N348I mutation in patient failing combination antiretroviral treatment In Botswana Boitumelo Seraise, Kerstin Andrea-Marobela, Sikhulile Moyo, Rosemary Musonda, Joseph Makhema, Max Essex, Simani Gaseitsiwe
Collapse
|
44
|
Smit J, López-Cortés LE, Kaasch AJ, Søgaard M, Thomsen RW, Schønheyder HC, Rodríguez-Baño J, Nielsen H. Gender differences in the outcome of community-acquired Staphylococcus aureus bacteraemia: a historical population-based cohort study. Clin Microbiol Infect 2016; 23:27-32. [PMID: 27343816 DOI: 10.1016/j.cmi.2016.06.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/06/2016] [Accepted: 06/08/2016] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Female gender has been suggested to be associated with poor outcome in patients with Staphylococcus aureus bacteraemia (SAB), but existing data remain sparse and conflicting. We investigated clinical outcomes in female and male patients with community-acquired (CA-) SAB. METHODS Population-based medical registers were used to conduct a cohort study of all adult patients with CA-SAB in northern Denmark, 2000-2011. Thirty-day mortality after CA-SAB for female and male patients was estimated by the Kaplan-Meier method. Using Cox proportional hazards regression, we computed hazard ratios (HRs) of death according to gender, overall and stratified by age groups, co-morbidity level, and selected major diseases while adjusting for potential confounders. Moreover, we estimated 30-day prevalence proportions for SAB-associated infective endocarditis and osteomyelitis by gender. RESULTS Among 2638 patients with CA-SAB, 1022 (39%) were female. Thirty-day mortality was 29% (n = 297) in female patients and 22% (n = 355) in male patients, yielding an adjusted HR (aHR) of 1.30 (95% CI, 1.11-1.53). This association appeared robust across age groups, whereas no consistent pattern was observed according to co-morbidity level. Compared with male patients, the prognostic impact of gender was most pronounced among female patients with diabetes (aHR 1.52; 95% CI 1.04-2.21)), and among female patients with cancer (aHR 1.40; 95% CI 1.04-1.90). The 30-day prevalence of infective endocarditis or osteomyelitis did not differ according to gender. CONCLUSION Female patients with CA-SAB experienced increased 30-day mortality compared with male patients. Gender should be considered in the triage and risk stratification of CA-SAB patients.
Collapse
Affiliation(s)
- J Smit
- Department of Clinical Microbiology, Aalborg University Hospital, Denmark; Department of Infectious Diseases, Aalborg University Hospital, Denmark; Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.
| | - L E López-Cortés
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospitales Universitarios Virgen Macarena y Virgen del Rocío, Sevilla, Spain
| | - A J Kaasch
- Institute of Medical Microbiology and Hospital Hygiene, Heinrich Heine University, Düsseldorf, Germany
| | - M Søgaard
- Department of Clinical Epidemiology, Aarhus University Hospital, Denmark
| | - R W Thomsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Denmark
| | - H C Schønheyder
- Department of Clinical Microbiology, Aalborg University Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark
| | - J Rodríguez-Baño
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospitales Universitarios Virgen Macarena y Virgen del Rocío, Sevilla, Spain; Facultad de Medicina, Universidad de Sevilla, Spain
| | - H Nielsen
- Department of Infectious Diseases, Aalborg University Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark
| |
Collapse
|
45
|
Mihajlovic L, Radosavljevic J, Nordlund E, Krstic M, Bohn T, Smit J, Buchert J, Cirkovic Velickovic T. Peanut protein structure, polyphenol content and immune response to peanut proteins in vivo are modulated by laccase. Food Funct 2016; 7:2357-66. [DOI: 10.1039/c5fo01325a] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Laccase cross-linking of peanut protein causes changes in the protein structure, phenolic composition and immunological properties of the treated peanut protein.
Collapse
Affiliation(s)
- L. Mihajlovic
- University of Belgrade
- Faculty of Chemistry
- Belgrade
- Serbia
| | | | | | - M. Krstic
- University of Belgrade
- Faculty of Chemistry
- Belgrade
- Serbia
| | - T. Bohn
- Centre de Recherche Public – Gabriel Lippmann
- Belvaux
- Luxembourg
| | - J. Smit
- Institute for Risk Assessment Sciences
- Utrecht University
- Utrecht
- Netherlands
| | - J. Buchert
- National Food Resources Institute (Luke)
- Helsinki
- Finland
| | | |
Collapse
|
46
|
Beksinska ME, Smit J, Greener R, Todd CS, Lee MLT, Maphumulo V, Hoffmann V. Acceptability and performance of the menstrual cup in South Africa: a randomized crossover trial comparing the menstrual cup to tampons or sanitary pads. J Womens Health (Larchmt) 2015; 24:151-8. [PMID: 25682816 DOI: 10.1089/jwh.2014.5021] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In low-income settings, many women and girls face activity restrictions during menses, owing to lack of affordable menstrual products. The menstrual cup (MC) is a nonabsorbent reusable cup that collects menstrual blood. We assessed the acceptability and performance of the MPower® MC compared to pads or tampons among women in a low-resource setting. METHODS We conducted a randomized two-period crossover trial at one site in Durban, South Africa, between January and November 2013. Participants aged 18-45 years with regular menstrual cycles were eligible for inclusion if they had no intention of becoming pregnant, were using an effective contraceptive method, had water from the municipal system as their primary water source, and had no sexually transmitted infections. We used a computer-generated randomization sequence to assign participants to one of two sequences of menstrual product use, with allocation concealed only from the study investigators. Participants used each method over three menstrual cycles (total 6 months) and were interviewed at baseline and monthly follow-up visits. The product acceptability outcome compared product satisfaction question scores using an ordinal logistic regression model with individual random effects. This study is registered on the South African Clinical Trials database: number DOH-27-01134273. RESULTS Of 124 women assessed, 110 were eligible and randomly assigned to selected menstrual products. One hundred and five women completed all follow-up visits. By comparison to pads/tampons (usual product used), the MC was rated significantly better for comfort, quality, menstrual blood collection, appearance, and preference. Both of these comparative outcome measures, along with likelihood of continued use, recommending the product, and future purchase, increased for the MC over time. CONCLUSION MC acceptance in a population of novice users, many with limited experience with tampons, indicates that there is a pool of potential users in low-resource settings.
Collapse
Affiliation(s)
- Mags E Beksinska
- 1 Department of Obstetrics and Gynaecology, Maternal, Adolescent and Child Health Research, University of the Witwatersrand , Durban, South Africa
| | | | | | | | | | | | | |
Collapse
|
47
|
|
48
|
Paschke R, Schlumberger M, Nutting C, Jarzab B, Elisei R, Siena S, Bastholt L, de la Fouchardiere C, Pacini F, Shong YK, Sherman SI, Smit J, Kappeler C, Molnar I, Brose MF. Exploratory analysis of outcomes for patients with locally advanced or metastatic radioactive iodine-refractory differentiated thyroid cancer (RAI-RDTC) receiving open-label Sorafenib post-progression on the phase III decision trial. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
49
|
Paschke R, Schlumberger M, Elisei R, Pacini F, Jarzab B, Giannetta L, Bastholt L, de la Fouchardiere C, Worden FP, Shong YK, Smit J, Kappeler C, Molnar I, Brose MF. Prognostic and predictive factors correlated with treatment outcomes for radioactive iodine-refractory differentiated thyroid cancer (RAI-RDTC) patients receiving Sorafenib or placebo on the phase III decision trial. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
50
|
Beksinska M, Smit J, Greener R, Piaggio G, Joanis C. The female condom learning curve: patterns of female condom failure over 20 uses. Contraception 2015; 91:85-90. [DOI: 10.1016/j.contraception.2014.09.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 08/29/2014] [Accepted: 09/22/2014] [Indexed: 11/28/2022]
|