HIV self-screening distribution preferences and experiences among men who have sex with men in Mpumalanga Province: Informing policy for South Africa

Current research suggests that HIV self-screening (HIVSS) is a feasible and acceptable approach to increase HIV testing among men who have sex with men (MSM). However, few data are available to shape policy around dissemination and implementation. Gaps in knowledge include preferences for distribution of HIVSS kits, potential social harms and benefits of their use, and how much test users would be willing to pay for the kits. The aim was to inform policy recommendations to optimise distribution of HIVSS kits to MSM in South Africa (SA), where there is a high HIV incidence and unmet testing needs. MSM in the high-HIV-prevalence Gert Sibande and Ehlanzeni districts of Mpumalanga Province, SA, were enrolled between October 2015 and May 2017. Participants were provided with their choice of blood or oral fluid HIVSS test kits, receiving 5 kits at enrolment and 4 additional kits at the 3-month follow-up visit. Questionnaires were administered at enrolment, 3 months and 6 months. We analysed participants’ reported social benefits and harms, and their preferences for kit distribution and pricing. Among 127 MSM screened and enrolled, 114 responded to follow-up questionnaires regarding distribution preferences, 49.3% preferred to acquire HIVSS kits at a community-based organisation (CBO) and 42.7% at a clinic, with 8% preferring a pharmacy. Participants with higher education preferred CBO sites for distribution; in other respects preferences were similar by demographic characteristics. Reported social benefits were common, including knowing one’s status, prevention knowledge gained and improved communication with partners. Despite ubiquitous interest in using the kits, the majority of MSM could not afford to purchase test kits. SA guidelines have integrated HIVSS into HIV and testing policy, but little has been published regarding distribution channels of the kits for MSM and other key populations. There is a partnership between the National Department of Health and CBOs that specialise in key population programming to ensure MSM and other populations with unmet testing needs can access affordable test kits. We observed no social harms, and there were multiple social benefits. Consequently, we recommend immediate free or low-cost distribution of HIVSS kits to MSM through community-based initiatives. Future research should continue to assess optimised linkage to care

Correlates of viral suppression among sexual minority men and transgender women living with HIV in Mpumalanga, South Africa

Sexual minority men (SMM) and transgender women in South Africa engage in HIV care at lower rates than other persons living with HIV and may experience population-specific barriers to HIV treatment and viral suppression (VS). As part of a pilot trial of an SMM-tailored peer navigation (PN) intervention in Ehlanzeni district, South Africa, we assessed factors associated with ART use and VS among SMM at trial enrolment. A total of 103 HIV-positive SMM and transgender women enrolled in the pilot trial. Data on clinical visits and ART adherence were self-reported. VS status was verified through laboratory analysis (<1000 copies/ml). We assessed correlates of VS at baseline using Poisson generalized linear model (GLM) with a log link function, including demographic, psychosocial, clinical, and behavioral indicators. Among participants, 52.4% reported ART use and only 42.2% of all participants had evidence of VS. Of the 49.5% who reported optimal engagement in HIV care (consistent clinic visits with pills never missed for ≥ 4 consecutive days) in the past 3-months, 56.0% were virally suppressed. In multivariable analysis, SMM were significantly more likely to be virally suppressed when they were ≥ 25 years of age (Adjusted prevalence ratio [APR] = 2.0, CI 95%:1.0-3.8); in a relationship but not living with partner, as compared to married, living together, or single (APR = 1.7, CI 95%:1.0-2.7), and optimally engaged in care (APR = 2.1, 95% CI:1.3-3.3). Findings indicate a need for targeted treatment and care support programming, especially for SMM and transgender women who are young and married/living with their partners to improve treatment outcomes among this population

HIV selfscreening distribution preferences and experiences among men who have sex with men in Mpumalanga Province: Informing policy for South Africa

Current research suggests that HIV self-screening (HIVSS) is a feasible and acceptable approach to increase HIV testing among men who have sex with men (MSM). However, few data are available to shape policy around dissemination and implementation. Gaps in knowledge include preferences for distribution of HIVSS kits, potential social harms and benefits of their use, and how much test users would be willing to pay for the kits. The aim was to inform policy recommendations to optimise distribution of HIVSS kits to MSM in South Africa (SA), where there is a high HIV incidence and unmet testing needs. MSM in the high-HIV-prevalence Gert Sibande and Ehlanzeni districts of Mpumalanga Province, SA, were enrolled between October 2015 and May 2017. Participants were provided with their choice of blood or oral fluid HIVSS test kits, receiving 5 kits at enrolment and 4 additional kits at the 3-month follow-up visit. Questionnaires were administered at enrolment, 3 months and 6 months. We analysed participants’ reported social benefits and harms, and their preferences for kit distribution and pricing. Among 127 MSM screened and enrolled, 114 responded to follow-up questionnaires regarding distribution preferences, 49.3% preferred to acquire HIVSS kits at a community-based organisation (CBO) and 42.7% at a clinic, with 8% preferring a pharmacy. Participants with higher education preferred CBO sites for distribution; in other respects preferences were similar by demographic characteristics. Reported social benefits were common, including knowing one’s status, prevention knowledge gained and improved communication with partners. Despite ubiquitous interest in using the kits, the majority of MSM could not afford to purchase test kits. SA guidelines have integrated HIVSS into HIV and testing policy, but little has been published regarding distribution channels of the kits for MSM and other key populations. There is a partnership between the National Department of Health and CBOs that specialise in key population programming to ensure MSM and other populations with unmet testing needs can access affordable test kits. We observed no social harms, and there were multiple social benefits. Consequently, we recommend immediate free or low-cost distribution of HIVSS kits to MSM through community-based initiatives. Future research should continue to assess optimised linkage to care

Municipal solid waste data quality on artificial neural network performance

Abstract: Short and long-term municipal solid waste (MSW) management requires adequate planning. Understanding the relationship among variables that affect MSW generation and predicting MSW based on them is needed for an effective planning. Methodologies to forecast MSW are numerous and have been implemented at different level of data granularity. Lack of data in many African cities and countries has hampered effective waste management plan. The lack of data has mainly been attributed to insufficient budget and lack of capacity to implement such management structure. In this study, we investigated the impact of data quality on forecasting efficiency using advanced prediction techniques. It was observed that the quality of waste related data variables determines the extent of model reliability and prediction accuracy

A Study on the Market Potential of Biomass-Based Micro Gas Turbines in SubSaharan Africa

Selection and peer-review under responsibility of the scientific committee of the 13th Int. Conf. on Applied Energy (ICAE2021).Biomass can be used as an alternative fuel in micro gas turbines to produce electricity, heat and/ or cooling. This is an affordable carbon-neutral renewable energy source which is widely available in most African countries. In this project the main aim is to gather information and data to evaluate the feasibility and the market potential of this technology in three sub-Saharan African countries. This includes data about the energy market, information on feedstock availability in different regions, statistics on the electricity grid, the demand profiles of different consumers, as well as insight on the national policies and regulation. The information is used to help understand the needs of the energy market in the partner countries and the potential of the proposed technology.Global Challenges Research Fund (GCRF), provided by Research England

A review on factors affecting municipal solid waste generation

Abstract: Municipal solid waste (MSW) management is not a one-off planning, it is a dynamic evolution and planning has to cater for it. The quantity of MSW generated and composition form the basis for planning and management of MSW. However, for an effective MSW reduction policy to be implemented, generated quantity of MSW is not sufficient alone for policy implementation but more of the variables affecting the generation rate and composition are critical. Without an in-depth understanding of these variables, waste reduction policies may be ineffective and unsuccessful. In this study, we reviewed the impact of these factors on MSW. A case of the City of Johannesburg (CoJ) was studied. Population and gross domestic product (GDP) are the two compelling factors affecting MSW generation. The waste generation per capita is influenced by income level. High income group generate on average 1.91 kg/capita/day, middle income group generates 1.01 kg/capita/day and low income group 0.92 kg/capita/day. This put the CoJ total waste generated at an average of 1.83 million ton/year

A Study on the Market Potential of Biomass-Based Micro Gas Turbines in Sub-Saharan Africa

Biomass can be used as an alternative fuel in micro gas turbines to produce electricity, heat and/ or cooling. This is an affordable carbon-neutral renewable energy source which is widely available in most African countries. In this project the main aim is to gather information and data to evaluate the feasibility and the market potential of this technology in three sub-Saharan African countries. This includes data about the energy market, information on feedstock availability in different regions, statistics on the electricity grid, the demand profiles of different consumers, as well as insight on the national policies and regulation. The information is used to help understand the needs of the energy market in the partner countries and the potential of the proposed technology

Increases in HIV status disclosure and sexual communication between South African men who have sex with men and their partners following use of HIV self-testing kits

Availability of HIV self-testing may increase HIV testing frequency among men who have sex with men (MSM). It is unclear, however, if self-testing may impact HIV-related sexual behaviors among MSM, including HIV status disclosure and condom use. We conducted a mixed methods analysis of changes in HIV-related behaviors after HIV self-testing introduction, using data from 110 MSM participating in a feasibility and acceptability study of HIV self-testing in Mpumalanga Province, South Africa. We found increased HIV status disclosure from study participants to sexual partners after HIV self-testing introduction, from 61.8% at baseline to 75.5% at 6-month follow-up (p = 0.04), but decreased condom use with female partners (p = 0.03). Qualitative interviews reveal that some participants used test results to inform condom use. Distribution of self-testing kits can improve mutual disclosure, but should be accompanied by information stressing that the tests may not detect early HIV infections or other sexually transmitted infections