Download or read book Understanding Factors that Influence Pre exposure Prophylaxis Efficacy for HIV 1 Prevention written by Pamela M. Murnane and published by . This book was released on 2014 with total page 81 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pre-exposure prophylaxis (PrEP) is a promising new HIV-1 prevention strategy, with demonstrated efficacy from four randomized clinical trials. However, two trials of PrEP, both among heterosexual African women, did not find efficacy for protection against HIV-1. While adherence to PrEP has been proposed as the primary driver of the range of results across trials, other factors warrant investigation. This dissertation work contributes to our understanding of behavioral and biological factors that influence the effectiveness of PrEP and aims to inform PrEP implementation strategies. This dissertation was conducted within the Partners PrEP Study, a placebo-controlled, randomized trial of daily oral PrEP among 4747 heterosexual HIV-1 serodiscordant couples (one partner is infected with HIV-1 and the other partner is uninfected) in Kenya and Uganda which demonstrated high efficacy for two daily oral PrEP regimens, tenofovir alone and co-formulated tenofovir-emtricitabine. In a series of secondary analyses of data from the Partners PrEP Study, we evaluated the effect of PrEP among high-risk subgroups to determine whether efficacy was sustained in the context of high HIV exposure, we estimated the causal effect of PrEP when adherence was estimated to be high by applying multiple methods to correct for non-adherence in randomized trials, and we assessed whether PrEP adversely impacted hormonal contraceptive effectiveness for pregnancy prevention, as young women are a priority population for HIV prevention. The work presented here supports the hypothesis that the key driver of divergent PrEP trial results was adherence, and indicates that oral PrEP is highly effective for women and men, reducing HIV-1 risk by over 80% when estimated to have been used with high adherence. These analyses contribute to a more nuanced understanding of how PrEP works and inform guidelines for initiating PrEP among persons at risk of HIV-1 acquisition.

Download or read book Disease Control Priorities Third Edition Volume 6 written by King K. Holmes and published by World Bank Publications. This book was released on 2017-11-06 with total page 1027 pages. Available in PDF, EPUB and Kindle. Book excerpt: Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.

Download or read book Handbook of Antimicrobial Resistance written by Matthias Gotte and published by Springer. This book was released on 2018-02-12 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: While many volumes have been written about various aspects of antimicrobial resistance, this book is a comprehensive reference work. All manifestations of resistance are addressed: viral; bacterial, parasitical and fungal are given dedicated sections. The underlining molecular mechanisms, which depend not only on the microbe but on the specific drug (target), are highly diverse. This work discusses and compares the biological, biochemical and structural aspects of resistance and its evolution.

Download or read book Individual and Social Network Influences on Potential Use of Pre exposure Prophylaxis for HIV Prevention Among Adult Black Women written by Whitney Chivonne Sewell and published by . This book was released on 2019 with total page 195 pages. Available in PDF, EPUB and Kindle. Book excerpt: Oral daily pre-exposure prophylaxis (PrEP) is a single tablet that is >90% effective in reducing HIV transmission among women. Despite evidence of PrEP's efficacy and safety, levels of awareness, prescription, and uptake of PrEP among Black women are disproportionately low. There is evidence suggesting that the influence of peers and sexual partners in the social networks of Black women are potential facilitators and barriers to the intent to use PrEP. However, there has been limited study examining how these individual and social network level factors influence the intent to use PrEP in this population. This dissertation collected used survey data from Black women, aged 18-44, to conduct advanced statistical analysis, including social network analysis, to identify critical individual and network level factors that influence PrEP uptake. This study found strong associations between PrEP support from sexual partners and healthcare providers and intent to use PrEP in this sample. This study builds upon existing research on PrEP and women by contributing to discussions about the importance of social connections in making the decision to engage in PrEP care and services.

Download or read book Remaking HIV Prevention in the 21st Century written by Sarah Bernays and published by Springer Nature. This book was released on 2021-07-26 with total page 305 pages. Available in PDF, EPUB and Kindle. Book excerpt: This edited collection brings together the social dimensions of three key aspects of recent biomedical advance in HIV research: Treatment as Prevention (TasP), new technologies such as Pre-Exposure Prophylaxis (PrEP), and the Undetectable equals Untransmittable (U=U) movement. The growth of new forms of biomedical HIV prevention has created hope for the future, signalling the possibility of a world without AIDS. In this context, the volume discusses the profound social, political and ethical dilemmas raised by such advances, which are to do with readiness, access, equity and availability. It examines how HIV prevention has been, and is, re-framed in policy, practice and research, and asks: How best can new biomedical technologies be made available in a profoundly unequal world? What new understandings of responsibility and risk will emerge as HIV becomes a more manageable condition? What new forms of blame will emerge in a context where the technologies to prevent HIV exist, but are not always used? How best can we balance public health’s concern for adherence and compliance with the rights of individuals to decide on what is best for themselves and others? Few of these questions have thus far received serious consideration in the academic literature. The editors, all leaders in the social aspects of HIV, have brought together an innovative and international collection of essays by top thinkers and practitioners in the field of HIV. This book is an important resource for academics and professionals interested in HIV research. Chapters "Anticipating Policy, Orienting Services, Celebrating Provision: Reflecting on Scotland’s PrEP Journey", "How the science of HIV treatment-as-prevention restructured PEPFAR’s strategy: The case for scaling up ART in ‘epidemic control’ countries", "Stigma and confidentiality indiscretions: Intersecting obstacles to the delivery of Pre-Exposure Prophylaxis to adolescent girls and young women in east Zimbabwe" and "The drive to take an HIV test in rural Uganda: a risk to prevention for young people?" are available open access under a Creative Commons Attribution 4.0 International License via link.springer.com.

Download or read book Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection written by World Health Organization and published by . This book was released on 2016 with total page 429 pages. Available in PDF, EPUB and Kindle. Book excerpt: These guidelines provide guidance on the diagnosis of human immunodeficiency virus (HIV) infection, the use of antiretroviral (ARV) drugs for treating and preventing HIV infection and the care of people living with HIV. They are structured along the continuum of HIV testing, prevention, treatment and care. This edition updates the 2013 consolidated guidelines on the use of antiretroviral drugs following an extensive review of evidence and consultations in mid-2015, shared at the end of 2015, and now published in full in 2016. It is being published in a changing global context for HIV and for health more broadly.

Download or read book Private Choices and Public Health written by Tomas J. Philipson and published by Harvard University Press. This book was released on 1993 with total page 290 pages. Available in PDF, EPUB and Kindle. Book excerpt: An economics professor and a federal judge point out that engaging in unprotected sex is a dangerous but pleasurable activity, like downhill skiing and mountain climbing, and that people weigh the risks and benefits when deciding whether or not to do it. The people setting up public health measures to combat the spread of AIDS, they say, are not taking this informed and often rational decision-making into account. Therefore, their predictions are off and their information campaigns are not only in effective, but may well be encouraging the disease's spread. They also look at the cost and benefits of research and education for the society as a whole. The book is bound to be controversial. Annotation copyright by Book News, Inc., Portland, OR

Download or read book Understanding the Influence of Socio ecological Factors on Preexposure Prophylaxis PrEP Use in Adolescent Girls and Young Women in Africa written by Geetha Beauchamp and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: African adolescent girls and young women (AGYW) have one of the highest global HIV incidence rates despite increased access to highly effective oral preexposure prophylaxis (PrEP) for prevention, HIV testing, and linkage-to-care/viral suppression among men. Inconsistent PrEP adherence undermines PrEP benefits for AGYW. Qualitative research suggests that barriers to PrEP adherence include fear of disclosure of PrEP use, stigma, provider distrust, and poor social support. A reliable tool for predicting AGYW’s “PrEP readiness” would help identify who could benefit from greater PrEP adherence support. An improved understanding of the pathways affecting AGYW’s adherence is crucial to advancing adherence strategies. This research used data from the open-label HPTN 082 study conducted among AGYW (ages16-25 years) in South Africa and Zimbabwe. The HIV Prevention Readiness Measure (HPRM) questionnaire was adapted from the validated HIV Treatment Readiness Measure, which predicted viral suppression in HIV-positive youth in the U.S. The HPRM was administered to HPTN 082 participants at enrollment and again three months later. The aims of this research were to 1) evaluate the psychometric properties and the utility of the HPRM to predict PrEP adherence; 2) investigate the association between PrEP disclosure and adherence and whether it was moderated by social support and mediated through PrEP support; and 3) assess whether mistrust in the study team was associated with discordance between patient-reported PrEP adherence and an objective biomarker of PrEP adherence, intracellular tenofovir-diphosphate drug concentrations. The findings were: 1) overall HPRM score and the three subscales (self-efficacy, disclosure of PrEP use, and social support) are reliable and predicted increased PrEP adherence; and disclosure of PrEP use increased the odds of persistent adherence; 2) AGYW with supportive adults in their life and disclosed PrEP use to their parents had higher adherence; and 3) AGYW who expressed high trust in their providers had higher odds of both high self-reported and drug level measures of PrEP adherence. The research makes three significant contributions to improving PrEP delivery: 1) HPRM as a tool to assess PrEP readiness and focus adherence support on AGYW who have low self-efficacy, low social support, and no plans for disclosing PrEP use; 2) supporting AGYW to consider disclosing their PrEP use to the supportive adults in their lives; and 3) in provider PrEP training, discuss the importance of AGYW’s trust in their provider as essential to improving AGYW reporting actual PrEP use.

Download or read book Structural Interventions for HIV Prevention written by Richard A. Crosby and published by Oxford University Press. This book was released on 2018-10-26 with total page 441 pages. Available in PDF, EPUB and Kindle. Book excerpt: A COMPREHENSIVE NEW REFERENCE WORK ON STRUCTURAL APPROACHES TO PREVENTING HIV Structural interventions -- changes to environment aimed at influencing health behaviors -- are the most universal and cost-effective tool in preventing new incidences of HIV. They are not easy to get right, however. Structural Interventions for HIV Prevention offers an authoritative reference for both understanding these programs and instituting them to greatest effect. Whether through changes to policy, environment, social/community norms, or a combination of each, this volume offers actionable and attainable blueprints to creating and evaluating programs in any setting or country. It is an essential resource for researchers and practitioners in the continuing fights against HIV.

Download or read book Depression and HIV Pre exposure Prophylaxis Use Among Sub Saharan African Women written by Jennifer Velloza and published by . This book was released on 2019 with total page 140 pages. Available in PDF, EPUB and Kindle. Book excerpt: Daily, oral pre-exposure prophylaxis (PrEP) with emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) is a highly efficacious HIV prevention strategy for key populations at high risk of HIV, including women, in sub-Saharan Africa. However, open-label studies and demonstration projects have reported that young women have difficulty adhering to PrEP over time, which limits its effectiveness as a prevention option. PrEP projects are now exploring modifiable barriers to adherence among women to maximize its public health benefit as it is being rapidly rolled out worldwide. Mental health factors, including depression, traumatic stress symptoms, and stigma, are highly prevalent among women at high risk of HIV acquisition and are barriers to medication use and health promotion behaviors. However, there has been little consideration until now of how such factors might also influence PrEP adherence among women in sub-Saharan Africa. The aims in this dissertation attempt to fill this research gap by: 1) exploring the impact of depressive symptoms on PrEP adherence among women; 2) examining the mechanisms by which depressive symptoms influence PrEP adherence; 3) describing the broader context of HIV-related stigma and empowerment on PrEP use; and 4) integrating depression screening into HIV care delivery to improve mental health and HIV outcomes. Two studies have examined the influence of depression on PrEP adherence and found that depressive symptoms have a negative effect on daily PrEP use for transgender women and men who have sex with men. Ours is the first study to examine links between depression and PrEP adherence among cisgender women in sub-Saharan Africa. We used marginal structural models to estimate the association between depressive symptoms and PrEP adherence while adjusting for time-varying confounding by sexual behavior, stigma, and social support. We found that probable depression was significantly associated with poor PrEP adherence among women, but not men, suggesting that mental health and depression experiences have differential impact on HIV prevention behaviors by gender. This work also led to questions about the mechanism of this association and whether there were important mediators of the relationship between depression and PrEP adherence that could explain at least some of this total effect. We conducted a mediation analysis using marginal structural models to estimate the controlled direct effect of depression on PrEP adherence, after accounting for the potentially mediating influence of HIV-related stigma, social support, and optimism about PrEP effectiveness. We found a significant negative direct influence of depression on PrEP adherence but this relationship was not strongly mediated by other psychosocial factors. Future research is needed to explore additional potential mediators of this relationship and identify areas for intervention. Qualitative research methods allow us to explore narratives around PrEP use, experiences of stigma, and concerns about mental health that are not captured by quantitative data. We analyzed serial in-depth interview data from a cohort of young women using PrEP to understand the broader context around their pill-taking, mental health, and relationships. In this study, we found that women described experiences of HIV-related stigma when they began taking PrEP which influenced their ability to take PrEP and their feelings about themselves. However, over time, women became more empowered to use PrEP and combat HIV-related stigma by becoming "ambassadors" of PrEP in their communities. This work highlights the potential for empowerment-based interventions to improve PrEP adherence and reduce community stigma and the richness of serially collected qualitative data. In Aims 1-3, we found evidence of a strong negative impact of depression on PrEP adherence and high rates of depression among women at risk of HIV. This work suggests that integrated depression screening and treatment with HIV prevention service delivery could improve mental health outcomes and PrEP effectiveness for women. To support the design of future integrated interventions, we conducted cognitive interviews assessing comprehensibility and acceptability of a widely used depression screening tool in the context of a PrEP delivery intervention among pregnant and postpartum women in Thika, Kenya. We found that the tool was largely acceptable and well-understood, but several minor changes to item wording and instructions would improve symptom screening and linkage to mental health care. These changes are part of our recommendations for the future use of this tool. The collective results presented in this dissertation illustrate the negative influence of depression and related psychosocial factors on consistent PrEP use for women, opportunities for stigma-reduction and empowerment-based intervention approaches to improve mental health symptoms and PrEP use in this population, and the potential to administer depression screening within the context of HIV prevention service delivery. This work contributes to a better understanding of the links between mental health and HIV risk for women and highlights the importance of integrating mental health and empowerment-based interventions with PrEP delivery to improve mental health screening and treatment and PrEP effectiveness for women in sub-Saharan Africa.

Download or read book Puberty written by Philip Kumanov and published by Springer. This book was released on 2016-08-30 with total page 298 pages. Available in PDF, EPUB and Kindle. Book excerpt: Bringing together the latest knowledge on the growth and development of children and the most important abnormalities of puberty, this comprehensive text presents the current views on the pathogenesis, diagnostic possibilities and therapeutic options of the main deviations from the normal course of puberty (e.g., precocious and delayed puberty). The chain of physical and hormonal changes in the transitional years is carefully followed, including the regulation of the hypothalamic pulse generator as well as the timing of puberty. Further topics include growth disturbances, adolescent varicocele, adolescent gynecomastia, polycystic ovary syndrome, pubertal acne, and the psychosocial development of adolescents with pubertal abnormalities. Written and edited by internationally noted experts, Puberty will be an excellent resource for pediatricians, endocrinologists, gynecologists, andrologists, urologists, family practitioners, child psychologists and public health specialists – all those who will be challenged in their everyday practice with the problems of puberty.

Download or read book HIV AIDS in South Africa 25 Years On written by Poul Rohleder and published by Springer Science & Business Media. This book was released on 2009-09-01 with total page 396 pages. Available in PDF, EPUB and Kindle. Book excerpt: Much has happened since the first appearance of AIDS in 1981: it has been identified, studied, and occasionally denied. The virus has shifted host populations and spread globally. Medicine, the social sciences, and world governments have joined forces to combat and prevent the disease. And South Africa has emerged as ground zero for the pandemic. The editors of HIV/AIDS in South Africa 25 Years On present the South African crisis as a template for addressing the myriad issues surrounding the epidemic worldwide, as the book brings together a widely scattered body of literature, analyzes psychosocial and sexual aspects contributing to HIV transmission and prevention, and delves into complex intersections of race, gender, class, and politics. Including largely overlooked populations and issues (e.g., prisoners, persons with disabilities, stigma), as well as challenges shaping future research and policy, the contributors approach their topics with rare depth, meticulous research, carefully drawn conclusions, and profound compassion. Among the topics covered: The relationship between HIV and poverty, starting from the question, "Which is the determinant and which is the consequence?" Epidemiology of HIV among women and men: concepts of femininity and masculinity, and gender inequities as they affect HIV risk; gender-specific prevention and intervention strategies. The impact of AIDS on infants and young children: risk and protective factors; care of children by HIV-positive mothers; HIV-infected children. Current prevention and treatment projects, including local-level responses, community-based work, and VCT (voluntary counseling and testing) programs. New directions: promoting circumcision, vaccine trials, "positive prevention." South Africa’s history of AIDS denialism. The urgent lessons in this book apply both globally and locally, making HIV/AIDS in South Africa 25 Years On uniquely instructive and useful for professionals working in HIV/AIDS and global public health.

Download or read book A Guide to the Clinical Care of Women with HIV written by Jean R. Anderson and published by DIANE Publishing Inc.. This book was released on 2005 with total page 636 pages. Available in PDF, EPUB and Kindle. Book excerpt: NOTE: NO FURTHER DISCOUNT FOR THIS PRODUCT ITEM -OVERSRTOCK SALE-- Significantly reduced price. Edited by Jean R. Anderson. This guide addresses the health care needs unique to women with HIV. It targets clinicians who provide primary care to women as well as those seeking an understanding of how to take care of women with HIV/AIDS. This guide includes tables, figures, color plates, resources, references, and indices. This 2005 edition includes new chapters on international issues and nutrition. Edge indexed."

Download or read book Problem solving Therapy written by Thomas J. D'Zurilla and published by Springer Publishing Company. This book was released on 1999 with total page 282 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Disease Control Priorities in Developing Countries written by Dean T. Jamison and published by World Bank Publications. This book was released on 2006-04-02 with total page 1449 pages. Available in PDF, EPUB and Kindle. Book excerpt: Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.

Download or read book Health in Humanitarian Emergencies written by David Townes and published by Cambridge University Press. This book was released on 2018-05-31 with total page 509 pages. Available in PDF, EPUB and Kindle. Book excerpt: A comprehensive, best practices resource for public health and healthcare practitioners and students interested in humanitarian emergencies.

Download or read book HIV AIDS written by Nancy Dumais and published by BoD – Books on Demand. This book was released on 2017-02-22 with total page 176 pages. Available in PDF, EPUB and Kindle. Book excerpt: With increasing efficacy of antiretroviral therapy, HIV/AIDS has shifted from a disease with high mortality to a chronic illness with substantial longevity. However, researchers, physicians and social workers still face many challenges, and it is important to raise awareness on several aspects that people living with HIV/AIDS have to deal in their daily lives. This book has assembled an array of chapters on the medical, social and economic aspects of HIV/AIDS. The chapters were written by experts from around the globe reflecting the importance of the topic. This book will be of great interest not only to graduate students but also to active academics and practitioners.