Do women with complications of an incomplete abortion have different HIV infection status than women without complications?

Thesis (Master's)--University of Washington, 2014Purpose: Little is known about the status of HIV among women who have had abortions and even less about women who have suffered from abortion complications. Understanding this connection is critical for building the evidence base and for guiding strategies to manage the sexual and reproductive health needs of women living with HIV. The purpose of this research is to assess if HIV infection status differed between women who suffered incomplete abortion complications and those who visited the hospital for other obstetric needs. Methods: The analysis used a secondary data set from a published case-control study that enrolled 1) women at discharge after receiving in-patient care for complications resulting from induced abortion, and 2) women (the comparison group) who visited the same hospital during the same time period for other obstetric needs. Unadjusted and adjusted associations between being in the abortion complications group, HIV status and other selected population characteristics were estimated using univariate and multivariate logistic regression. Results: Compared to women who were HIV negative, women who were HIV positive had similar odds of being in the abortion complications group in both univariate and multivariate analyses (ρ =0.62 and ρ = 0.76). However, compared to HIV-negative women, those women who did not know their HIV status had greater odds of being in the abortion complications group (OR=3.8, 95% CI, 1.88, 8.20) in univariate analysis. After adjusting for potential confounding variables, the odds of being in the abortion complications group remained greater among women who did not know their HIV status compared to HIV-negative women (adjusted OR = 2.8, 95% CI, 1.20, 6.54). Conclusions: Compared to HIV-negative women, HIV-positive women had similar odds of being in the abortion complications group. However, not knowing one's HIV status resulted in approximately three-fold higher odds of being in the abortion complications group compared to being HIV negative, pointing to the need for targeted interventions aimed at strengthening the delivery and coverage of HIV-testing programs for pregnant women and post-abortion care. In addition, further research examining the linkages between HIV and reproductive health is strongly recommended

Effects of a Large-Scale Unconditional Cash Transfer Program on Mental Health Outcomes of Young People in Kenya

PURPOSE: This study investigates the causal effect of Kenya's unconditional cash transfer program on mental health outcomes of young people. METHODS: Selected Locations in Kenya were randomly assigned to receive unconditional cash transfers in the first phase of Kenya's Cash Transfer Program for Orphans and Vulnerable Children (CT-OVC). In intervention Locations, low-income households and those with OVCs began receiving monthly cash transfers of $20 in 2007. In 2011, four years after program onset, data were collected on the psychosocial status for youth aged 15-24 from households in intervention and control Locations (N=1960). The primary outcome variable was an indicator of depressive symptoms using the 10-question Center for Epidemiologic Studies Depression Scale (CES-D10). Secondary outcomes include Hope and physical health measures. Logistic regression models that adjusted for individual and household characteristics were used to determine the effect of the cash transfer program. RESULTS: The cash transfer reduced the odds of depressive symptoms by 24 percent among young persons living in households that received cash transfers. Further analysis by gender and age revealed that the effects were only significant for young men and were larger among men aged 20-24 and orphans. CONCLUSIONS: This study provides evidence that poverty targeted unconditional cash transfer programs, can improve the mental health of young people in low-income countries