21 research outputs found
HIV Surveillance in a Large, Community-Based Study: Results from the Pilot Study of Project Accept (HIV Prevention Trials Network 043)
<p>Abstract</p> <p>Background</p> <p>Project Accept is a community randomized, controlled trial to evaluate the efficacy of community mobilization, mobile testing, same-day results, and post-test support for the prevention of HIV infection in Thailand, Tanzania, Zimbabwe, and South Africa. We evaluated the accuracy of in-country HIV rapid testing and determined HIV prevalence in the Project Accept pilot study.</p> <p>Methods</p> <p>Two HIV rapid tests were performed in parallel in local laboratories. If the first two rapid tests were discordant (one reactive, one non-reactive), a third HIV rapid test or enzyme immunoassay was performed. Samples were designated HIV NEG if the first two tests were non-reactive, HIV DISC if the first two tests were discordant, and HIV POS if the first two tests were reactive. Samples were re-analyzed in the United States using a panel of laboratory tests.</p> <p>Results</p> <p>HIV infection status was correctly determined based on-in country testing for 2,236 (99.5%) of 2,247 participants [7 (0.37%) of 1,907 HIV NEG samples were HIV-positive; 2 (0.63%) of 317 HIV POS samples were HIV-negative; 2 (8.3%) of 24 HIV DISC samples were incorrectly identified as HIV-positive based on the in-country tie-breaker test]. HIV prevalence was: Thailand: 0.6%, Tanzania: 5.0%, Zimbabwe 14.7%, Soweto South Africa: 19.4%, Vulindlela, South Africa: 24.4%, (overall prevalence: 14.4%).</p> <p>Conclusions</p> <p>In-country testing based on two HIV rapid tests correctly identified the HIV infection status for 99.5% of study participants; most participants with discordant HIV rapid tests were not infected. HIV prevalence varied considerably across the study sites (range: 0.6% to 24.4%).</p> <p>Trial Registration</p> <p>ClinicalTrials.gov registry number <a href="http://www.clinicaltrials.gov/ct2/show/NCT00203749">NCT00203749</a>.</p
Evaluation of a Peer Network-Based Sexual Risk Reduction Intervention for Men in Beer Halls in Zimbabwe: Results from a Randomized Controlled Trial
While much emphasis has been placed on involving men in AIDS prevention in sub-Saharan Africa, there remain few rigorously evaluated interventions in this area. A particularly appealing point of intervention is the sexual risk behavior associated with menās alcohol consumption. This article reports the outcomes of The Sahwira HIV Prevention Program, a male-focused, peer-based intervention promoting the idea that men can assist their friends in avoiding high-risk sexual encounters associated with alcohol drinking. The intervention was evaluated in a randomized, controlled trial (RCT) implemented in 24 beer halls in Harare, Zimbabwe. A cadre of 413 male beer hall patrons (~20% of the patronage) was trained to assist their male peers within their friendship networks. Activities included one-on-one interactions, small group discussions, and educational events centering on the theme of men helping their male friends avoid risk. Venues were randomized into 12 control versus 12 intervention beer halls with little cross-contamination between study arms. The penetration and impact of the intervention were assessed by pre- and post-intervention cross-sectional surveys of the beer hall patronage. The intervention was implemented with a high degree of fidelity to the protocol, with exposure to the intervention activities significantly higher among intervention patrons compared to control. While we found generally declining levels of risk behavior in both study arms from baseline to post-intervention, we found no evidence of an impact of the intervention on our primary outcome measure: episodes of unprotected sex with non-wife partners in the preceding 6Ā months (median 5.4 episodes for men at intervention beer halls vs. 5.1 among controls, PĀ =Ā 0.98). There was also no evidence that the intervention reduced other risks for HIV. It remains an imperative to find ways to productively engage men in AIDS prevention, especially in those venues where male bonding, alcohol consumption, and sexual risk behavior are intertwined
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Fieldwork processes, challenges and lessons of the recruitment of a qualitative cohort
Poster presentation at the 3rd South African AIDS Conference, Durban, South Africa, 5-8 Jul
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Strategies to improve adverse event (AE) reporting in a community based intervention trial in KwaZulu-Natal
Paper presented at the University of KwaZulu-Natal, 12th Annual Postgraduate Research Conference, Pietermaritzburg, South Africa, 13 Octobe
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Working with community based mobilisers (CBMs) to promote community-based voluntary counseling and testing in rural KwaZulu-Natal, South Africa
Paper presented at the University of KwaZulu-Natal, 12th Annual Postgraduate Research Conference, Pietermaritzburg, South Africa, 13 Octobe
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Gendered constructions of HIV risk in rural KwaZulu-Natal, South Africa
Paper presented at the 4th South African AIDS Conference, Durban, South Africa, 31 March - 4 Apri
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A comparative analysis of quantitative and qualitative HIV stigma data from a community based randomized trial in Kwa-Zulu Natal, South Africa (project Accept HPTN 043)
Poster presented at the XVII International AIDS Conference, Mexico City, 3-8 Augus
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Moving voluntary counselling and testing to the people
Social scientists are constantly trying to find new and pioneering ways to change sexual behaviour in the unrelenting battle against HIV. One proven method is to increase the uptake of voluntary counselling and testing (VCT). This is what Project Accept will try to achieve, writes Heidi van Rooyen, Admire Chirowodza, Sindisiwe Sikotoyi, Phillip Joseph and Linda Richter.
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Using participatory methods and geographic information systems (GIS) to prepare for an HIV community-based trial in Vulindlela, South Africa. Project Accept - HPTW 043
Recent attempts to integrate geographic information systems (GIS) and participatory techniques, have given rise to terminologies such as participatory GIS and community-integrated GIS. Although GIS was initially developed for physical geographic application, it can be used for the management and analysis of health and health care data. Geographic information systems, combined with participatory methodology, have facilitated the analysis of access to health facilities and disease risk in different populations. Little has been published about the usefulness of combining participatory methodologies and GIS technology in an effort to understand and inform community-based intervention studies, especially in the context of HIV. This article attempts to address this
perceived gap in the literature. The authors describe the application of participatory research methods with GIS in the formative phase of a multisite community-based social mobilization trial, using voluntary counseling and testing and post-test support as the intervention.
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Understanding the reproductive health, family planning and HIV prevention needs of couples in a rural community: preliminary findings from a pilot study in KwaZulu-Natal, South Africa
Poster presentation at the 4th South African AIDS Conference, Durban, South Africa, 31 March - 4 Apri