Factors predictive of successful retention in care among HIV-infected men in a universal test-and-treat setting in Uganda and Kenya: A mixed methods analysis.

BackgroundPrevious research indicates clinical outcomes among HIV-infected men in sub-Saharan Africa are sub-optimal. The SEARCH test and treat trial (NCT01864603) intervention included antiretroviral care delivery designed to address known barriers to HIV-care among men by decreasing clinic visit frequency and providing flexible, patient-centered care with retention support. We sought to understand facilitators and barriers to retention in care in this universal treatment setting through quantitative and qualitative data analysis.MethodsWe used a convergent mixed methods study design to evaluate retention in HIV care among adults (age > = 15) during the first year of the SEARCH (NCT01864603) test and treat trial. Cox proportional hazards regression was used to evaluate predictors of retention in care. Longitudinal qualitative data from n = 190 in-depth interviews with HIV-positive individuals and health care providers were analyzed to identify facilitators and barriers to HIV care engagement.ResultsThere were 1,863 men and 3,820 women who linked to care following baseline testing. Retention in care was 89.7% (95% CI 87.0-91.8%) among men and 89.0% (86.8-90.9%) among women at one year. In both men and women older age was associated with higher rates of retention in care at one year. Additionally, among men higher CD4+ at ART initiation and decreased time between testing and ART initiation was associated with higher rates of retention. Maintaining physical health, a patient-centered treatment environment, supportive partnerships, few negative consequences to disclosure, and the ability to seek care in facilities outside of their community of residence were found to promote retention in care.ConclusionsFeatures of the ART delivery system in the SEARCH intervention and social and structural advantages emerged as facilitators to retention in HIV care among men. Messaging around the health benefits of early ART start, decreasing logistical barriers to HIV care, support of flexible treatment environments, and accelerated linkage to care, are important to men's success in ART treatment programs. Men already benefit from increased social support following disclosure of their HIV-status. Future efforts to shift gender norms towards greater equity are a potential strategy to support high levels of engagement in care for both men and women

The Student Movement Volume 106 Issue 14: Climb Every Mountain, Tube Every Hill

HUMANS Getting to Know AU\u27s New Photography Professor Dan Weber. Interviewed by Karenna Lee Interview with BSCF President Khaylee Sands, Interviewed by: Timmy Duado Military to Music: Interview with Marcus Carter, Interviewed by: Grace No ARTS & ENTERTAINMENT Black Entertainers Who Inspire Me, Hannah Cruse In the Words of AU: Why Black Art is Important, Solana Campbell Know Your Roots by Marcel Mattox, Interviewed by: Kaela McFadden NEWS Embracing the New Normal, Jenae Rogers Mask Off: Andrews University Updates Covid-19 Guidelines, Abigail Lee Panic: Understanding the War Over Ukraine, Chris Ngugi Winter Storms Flurry Through the Midwest and the South, Nathan Mathieu IDEAS Kanye West and Paternal Accountability: Why it Matter, Alyssa Henriquez Should Joe Biden Cancel Student Debt? Who Has to Save The World?, Qualyn Robinson PULSE Cardinals vs. Golden Eagles: A Few Last Flights at the Season\u27s End, Alannah Tjhatra Fun Weekend Winter Activities, Shania Watts Thoughts on the Beijing 2022 Winter Olympics, Kaela McFadden THE LAST WORD Please Lamson Hall, Can I Have Some More?, Abigail Leehttps://digitalcommons.andrews.edu/sm-106/1013/thumbnail.jp

Predicting the long-term impact of antiretroviral therapy scale-up on population incidence of tuberculosis.

OBJECTIVE: To investigate the impact of antiretroviral therapy (ART) on long-term population-level tuberculosis disease (TB) incidence in sub-Saharan Africa. METHODS: We used a mathematical model to consider the effect of different assumptions about life expectancy and TB risk during long-term ART under alternative scenarios for trends in population HIV incidence and ART coverage. RESULTS: All the scenarios we explored predicted that the widespread introduction of ART would initially reduce population-level TB incidence. However, many modelled scenarios projected a rebound in population-level TB incidence after around 20 years. This rebound was predicted to exceed the TB incidence present before ART scale-up if decreases in HIV incidence during the same period were not sufficiently rapid or if the protective effect of ART on TB was not sustained. Nevertheless, most scenarios predicted a reduction in the cumulative TB incidence when accompanied by a relative decline in HIV incidence of more than 10% each year. CONCLUSIONS: Despite short-term benefits of ART scale-up on population TB incidence in sub-Saharan Africa, longer-term projections raise the possibility of a rebound in TB incidence. This highlights the importance of sustaining good adherence and immunologic response to ART and, crucially, the need for effective HIV preventive interventions, including early widespread implementation of ART

The Student Movement Volume 107 Issue 11: Have a Merry Christmas! XOXO, The Student Movement

HUMANS Coping with Finals, Solana Campbell Meet Jea Erazo, AUSA Public Relations Officer. Interviewed by: Caryn Cruz Remembering Sharon Dudgeon, Grace No Women in STEM: Olivia Joyce, Interviewed by: Gloria Oh ARTS & ENTERTAINMENT Football Sunday, Nathaniel Reid, Skylor Stark Student Picks: Christmas Classics, Ysabelle Fernando NEWS AFIA x MLS Christmas Party, Ceiry Flores Boycotts and Bans at the Qatar World Cup, Hannah Cruse In Loving Memory of Seth Williams, Gloria Oh IDEAS How Do We Address Queer Violence?, Alexander J. Hess Is Reality Really Real When You Aren\u27t Really Looking?, Alexander Navarro Reflecting on Christmas Traditions, Rachel Ingram-Clay The New Era of Book Bans, Elizabeth Getahun Why is Everyone so Happy During Christmastime?, Kayla-Hope Bruno PULSE Bon Appétit and the Threat to Cultural Autonomy, Wambui Karanja It\u27s OrnaMEANT to be a Wonderful Christmastime, Lexie Dunham It\u27s the Most Stressful Time of the Year, Reagan McCain Qatar Controversy: The Shadow Behind the World Cup, Melissa Moore Reflections on the Semester and Plans for Break, Elizabeth Dovich LAST WORD A Student Movement Christmas, The Student Movement Staffhttps://digitalcommons.andrews.edu/sm-107/1010/thumbnail.jp

The Student Movement Volume 16 Issue 19: Strut to the Beat of Your Own Drum: AUnited Serves Diversity Through Style

HUMANS Honors Research Scholar: Jessica Rim, Interviewed by: Lauren Kim Senior Spotlight: Matthew Shelton, Interviewed by: Timmy Duado Student Movement Editor-in-Chief Candidate: Alannah Tjhatra, Interviewed by: Karenna Lee ARTS & ENTERTAINMENT AU\u27s New Community Art Classes, Megan Napod Son of Man, I Have Made Thee a Watchman : An Update on The Watchmen Acapella, Interviewed by: Steven Injety The AUnited Fashion Show, Solana Campbell NEWS Spring Graduation Schedule 2022, From the President\u27s Office and the Graduation Committee Statement from Vice President Faehner on Instagram Harassment, Abigail Lee, Francis Faehner, and Alyssa Palmer Sexual Assault Awareness Month: Take Back the Night , Andrew Pak IDEAS How To: Get Rid of that One Friend that Always Drops By at the Worst Moments, Gabriela Francisco Money, Unionization, and Assumption, Yoel Kim Should Kids Be Raised With Minimal Technology?, Elizabeth Getahun The Anonymous Elephant in the Room, Abigail Lee PULSE Infusion Vespers 2022, Wambui Karanja Other User, Anonymous What We Want, What We Need: Student\u27s Hopes for AUSA, Alannah Tjhatra THE LAST WORD Engagement Above All, Kurt Kuhlmanhttps://digitalcommons.andrews.edu/sm-106/1018/thumbnail.jp

The Student Movement Volume 106 Issue 15: AU Theatre Wing Presents Pride and Prejudice

HUMANS Matchmaking by SASA - Details on the New Club Event!, Interviewed by: Irina Gagiu Meeting AU\u27s New Librarian, Katherine Van Arsdale Bell, Interviewed by: Grace No My Future Plans: Hannah Castillo, Interviewed by: Lauren Kim ARTS & ENTERTAINMENT Creative Spotlight: Students of the AU Theatre Wing, Interviewed by: Megan Napod New Artist Releases: Evin Nazya-Musgrove, Eli Wilson, & Jonathan Lutterodt, Solana Compbell The One Inch Barrier, Steven Injety NEWS Herbert Blomstedt Comes to Andrews University, Abigail Lee It\u27s for the Effect: A Student Response, Chris Ngugi Worship Concert, Healing Together , Andrew Pak IDEAS Are Attention Spans Decreasing?, Elizabeth Getahun Do I Have to Be a Parent?, Angelina Nesmith Naming the Familiar: Emotions, Experiences, & our Insufficient Language, Alexander Navarro PULSE Checking Out Rate My Professors , Gloria Oh Dorm Policies, Alannah Tjhatra Lessons I\u27ve Learned on My Year Abroad, Terika Williams THE LAST WORD A Friend, Taylor Uphushttps://digitalcommons.andrews.edu/sm-106/1014/thumbnail.jp

The peace that I wanted, I got: Qualitative insights from patient experiences of SMART DAPPER interventions for major depression and traumatic stress disorders in Kenya.

SMART DAPPER is an implementation science study responding to mental health treatment gaps for depression and trauma-related disorders in Sub-Saharan Africa (SSA). We report on patient experiences in a study using a Sequential, Multiple Assignment Randomized Trial (SMART) design to test first and second line non-specialist treatment using psychotherapy (Interpersonal Psychotherapy [IPT] or medication (fluoxetine [FLX]), integrated within public sector primary care in western Kenya. An embedded qualitative study conducted in-depth interviews (n = 17) and three (n = 3) focus group discussions with participants (May to October 2021). Audio-recorded interviews were transcribed and translated into English; we deductively and inductively analyzed transcripts guided by grounded theoretical approaches and content analysis. We drew on the health belief model and socio-ecological framework to present findings, including perceived severity (motivations for taking part in the intervention), impacts of the intervention at the individual, interpersonal, and community and health systems levels as well as barriers and facilitators. Participants discussed family and marital conflict, loss of a child, loss of income or a job, and traumatic events such as a death or illness. Impacts at the individual level included reduced headaches, improved appetite and weight management, increased energy, improved sleep, better self-efficacy, and improved concentration, which was reported to lead to increased economic opportunities. At the interpersonal level, participants noted a reduction in conflict, better conflict management and resolution, increased harmony with family and community members, and improved relationships with their partners and children. Perceived challenges included balancing the intervention with livelihoods, preference for traditional medicines, actual or anticipated side effects with medication (FLX), mental health stigma, major life events, and perceived inadequate counseling and challenges with providers. The findings demonstrate the potential of the SMART DAPPER intervention for depression and trauma-related disorder treatments and underscore the challenges and barriers that must be addressed when scaling similar interventions. Trial registration: ClinicalTrials.gov identifier: NCT03466346

The Student Movement Volume 106 Issue 10: Let\u27s Get This Gingerbread: AU Celebrates the Christmas Season

HUMANS Christmas with President Luxton - Memories, Traditions, & Favorites!, Interviewed by: Irina Gagiu My Christmas Wish..., Interviewed by: Grace No Semester Reflections with Ian Freed, Interviewed by: Timmy Duado ARTS & ENTERTAINMENT AU\u27s Christmas Playlist, Solana Campbell Creative Spotlight, Kayla Bruno (junior, psychology), Interviewed by: Megan Napod The Conundrum of Christmas Movies, Hannah Cruse NEWS A Very Merry Makarios Christmas Party, Nathan Mathieu Andrews Wind Symphony: Joy to the Season, Andrew Pak Winter Break Is Almost Here: Now What? IDEAS Master Your Sleep to Master Your Finals!, Robert Zhang Pollution and Progress: The Nuclear Dilemma Should We Lie To Kids About Santa?, Elizabeth Getahun PULSE A Yearly Theme Instead, T Bruggeman AUSA Christmas Light-Up, Karenna Lee Christmas Gift Ideas, Gloria Oh THE LAST WORD The Positives of a Global Pandemic, Alyssa Henriquezhttps://digitalcommons.andrews.edu/sm-106/1009/thumbnail.jp