HIV/AIDS and contraceptive method choice : demographic and socio-economic correlates of contraceptive method choice among HIV-positive women practising family planning in Kenya

Introduction: As the generalized HIV epidemic in specific settings of sub-Saharan Africa continues to evolve, there is need for evidence-based response to address emerging challenges, which include enabling the large number of women living with HIV make informed choices to achieve their reproductive goals. Objectives: This paper seeks to (i) examine the effect of HIV/AIDS on contraceptive method choice among women using contraceptives in Kenya; and (ii) identify correlates of contraceptive method choice among HIV-positive women practising family planning. Material and Methods: We apply multinomial Logistic regression models to a sample of 3190 sexually-active women of reproductive age using contraceptives from the 2003 and 2008 Kenya Demographic and Health Surveys to examine the effect of HIV/AIDS on contraceptive method choice. The analysis of correlates of method choice among HIV-positive women is based on a sample of 255 HIV-positive women using contraceptives and involves bivariate cross-tabulations with Chi-Square tests. Result: Overall association between HIV status and contraceptive method choice is consistent with expected patterns, with women who are HIV-positive being more than twice as likely to use condoms rather than hormonal contraceptives, compared to their counterparts of similar characteristics who are HIV-negative (p<0.05). Among women infected with HIV, those who were previously tested for HIV were more likely to use condoms and less likely to use hormonal methods (p<0.05) than those who had never been tested. The higher use of condoms by HIV-positive women is only evident among those who had previously been tested for HIV. Significant correlates of contraceptive method choice among HIV-positive women include parity, marital status, age group, education and ethnicity. Overall trends suggest a notable shift from use of hormonal methods to condoms by HIV-positive women, but predominant use of hormonal methods (60%) and low use of condoms (23%) by HIV-positive young women aged 15-24 practising family planning is of potential concern. Conclusion: The findings have important implications for family planning policies/programs targeting young women living with HIV and underscore the need to intensify efforts towards improved HIV testing coverage to enable HIV-positive women make informed reproductive choices

"Not right in the head": How should teachers assess new talk about teenagers?

Recently in New Zealand the Prime Minister's Chief Science Advisor has warned of changing circumstances creating a "powder keg" during adolescence, another top government advisor is reported as claiming young people's behaviour problems are the country's "biggest social issue", and the catchphrase of a parenting series on national television has been that teenagers are best understood as "not right in the head". Perhaps it is unsurprising that surveys have been reporting high levels of teacher stress and increasing levels of abuse and assault. Should secondary teaching therefore be considered a dubious career choice and a mass exodus from the profession anticipated? With regard to the implications for those whose lives continue to meet and mix in schools, this paper critically examines some of the local and overseas "expert talk" inspired by key features of scientific assertions regarding the changing nature of physical and cognitive development in adolescence

Understanding the urban-rural disparity in HIV and poverty nexus: the case of Kenya

Background The relationship between HIV and poverty is complex and recent studies reveal an urban-rural divide that is not well understood. This paper examines the urban-rural disparity in the relationship between poverty and HIV infection in Kenya, with particular reference to possible explanations relating to social cohesion/capital and other moderating factors. Methods Multilevel logistic regression models are applied to nationally-representative samples of 13,094 men and women of reproductive age from recent Kenya Demographic and Health Surveys. Results The results confirm a disproportionate higher risk of HIV infection among the urban poor, despite a general negative association between poverty and HIV infection among rural residents. Estimates of intra-community correlations suggest lower social cohesion in urban than rural communities. This, combined with marked socio-economic inequalities in urban areas is likely to result in the urban poor being particularly vulnerable. The results further reveal interesting cultural variations and trends. In particular, recent declines in HIV prevalence among urban residents in Kenya have been predominantly confined to those of higher socio-economic status. Conclusion With current rapid urbanization patterns and increasing urban poverty, these trends have important implications for the future of the HIV epidemic in Kenya and similar settings across the sub-Saharan Africa region

Amor y Apoyo: Lecciones de Latinx Families in Nourishing Resilience to First and Second-Generation College Students

The present qualitative study aims to understand how Latino/Hispanic herea er referred to as Latinx, parent involvement is different or similar among first- and second-generation college students in how they experience higher education and how parental education impacts the use of student support services. Hence, supporting Latinx student retention by developing university and parental relationships. Second-generation college students and Latinx parents were unable to be included in the study because of their scarcity or hesitation of participating. Therefore, participants included a convenience sample of six first-generation undergraduate students from a 4-year institution. Semi-structured interviews were conducted to obtain their stories of parental involvement and student involvement. Results suggest that (1) first-generation college students experience a hands-off involvement from parents, however, they enjoyed the freedom this brought, (2) Latinx parents might have a misunderstanding of college student identity, and (3) students expressed a desire to have their parents learn about and understand mental health. Implications of findings include universities creating more resources to support Latinx students’ mental health, as well as earlier school outreach for Latinx parent involvement to better inform them about the college lifestyle

Bayesian Model Selection Based on Proper Scoring Rules

Bayesian model selection with improper priors is not well-defined because of the dependence of the marginal likelihood on the arbitrary scaling constants of the within-model prior densities. We show how this problem can be evaded by replacing marginal log-likelihood by a homogeneous proper scoring rule, which is insensitive to the scaling constants. Suitably applied, this will typically enable consistent selection of the true model.Comment: Published at http://dx.doi.org/10.1214/15-BA942 in the Bayesian Analysis (http://projecteuclid.org/euclid.ba) by the International Society of Bayesian Analysis (http://bayesian.org/

Rejoinder to "Bayesian Model Selection Based on Proper Scoring Rules"

We are deeply appreciative of the initiative of the editor, Marina Vanucci, in commissioning a discussion of our paper, and extremely grateful to all the discussants for their insightful and thought-provoking comments. We respond to the discussions in alphabetical order [arXiv:1409.5291].Comment: Published at http://dx.doi.org/10.1214/15-BA942REJ in the Bayesian Analysis (http://projecteuclid.org/euclid.ba) by the International Society of Bayesian Analysis (http://bayesian.org/

Onset of sexual activity among adolescents in HIV/AIDS affected households in sub-Saharan Africa

This paper examines the effect of orphanhood and HIV status of adults in a household on onset of sexual activity among adolescent girls and boys aged 15-17 years in sub-Saharan Africa (SSA). We apply multilevel logistic models to pooled Demographic and Health Surveys data from19 countries of SSA where HIV test data were collected during 2003-2008 from nationally representative samples of men and women of reproductive age. The results highlight increased vulnerability among adolescent boys and girls living in households where an adult is infected with HIV, and adolescent boys who are paternal orphans. On average, adolescent boys and girls living in households where at least one adult is HIV-positive have about 25 percent higher odds of having initiated sexual activity compared to their counterparts of similar characteristics in households where no adult is HIV-positive. Furthermore, adolescent boys who are paternal orphans have about 25 percent higher odds of having initiated sexual activity than their non-orphan counterparts of similar individual characteristics. Further analysis reveals that household circumstances relating to living arrangements and poverty are important pathways through which household HIV/AIDS status is linked to adolescent sexual debut. The findings underscore the importance of international efforts in the SSA region to address the plight of other children in HIV/AIDS affected households, beyond orphans

Theory and Applications of Proper Scoring Rules

We give an overview of some uses of proper scoring rules in statistical inference, including frequentist estimation theory and Bayesian model selection with improper priors.Comment: 13 page

Kuhn-Tucker-based stability conditions for systems with saturation

This paper presents a new approach to deriving stability conditions for continuous-time linear systems interconnected with a saturation. The method presented can be extended to handle a dead-zone, or in general, nonlinearities in the form of piecewise linear functions. By representing the saturation as a constrained optimization problem, the necessary (Kuhn-Tucker) conditions for optimality are used to derive linear and quadratic constraints which characterize the saturation. After selecting a candidate Lyapunov function, we pose the question of whether the Lyapunov function is decreasing along trajectories of the system as an implication between the necessary conditions derived from the saturation optimization, and the time derivative of the Lyapunov function. This leads to stability conditions in terms of linear matrix inequalities, which are obtained by an application of the S-procedure to the implication. An example is provided where the proposed technique is compared and contrasted with previous analysis methods

Trends and determinants of contraceptive method choice in Kenya

This paper uses data from the 1989, 1993 and 1998 Kenya Demographic and Health Surveys to examine trends and determinants of contraceptive method choice. The analysis, based on two-level multinomial regression models, shows that, across years, use of modern contraceptive methods, especially long-term methods is higher in the urban than rural areas, while the pattern is reversed for traditional methods. Use of barrier methods among unmarried women is steadily rising, but the levels remain disappointingly low, particularly in view of the HIV/AIDS epidemic in Kenya. One striking result from this analysis is the dramatic rise in the use of injectables. Of particular program relevance is the notably higher levels of injectables use among rural women, women whose partners disapprove of family planning, uneducated women and those less exposed to family planning media messages, compared to their counterparts with better service accessibility and family planning information exposure