A Single-Blind randomized controlled trial to evaluate the effect of extended counseling on uptake of pre-antiretroviral care in eastern uganda

<p>Abstract</p> <p>Background</p> <p>Many newly screened people living with HIV (PLHIV) in Sub-Saharan Africa do not understand the importance of regular pre-antiretroviral (ARV) care because most of them have been counseled by staff who lack basic counseling skills. This results in low uptake of pre-ARV care and late treatment initiation in resource-poor settings. The effect of providing post-test counseling by staff equipped with basic counseling skills, combined with home visits by community support agents on uptake of pre-ARV care for newly diagnosed PLHIV was evaluated through a randomized intervention trial in Uganda.</p> <p>Methods</p> <p>An intervention trial was performed consisting of post-test counseling by trained counselors, combined with monthly home visits by community support agents for continued counseling to newly screened PLHIV in Iganga district, Uganda between July 2009 and June 2010, Participants (N = 400) from three public recruitment centres were randomized to receive either the intervention, or the standard care (the existing post-test counseling by ARV clinic staff who lack basic training in counseling skills), the control arm. The outcome measure was the proportion of newly screened and counseled PLHIV in either arm who had been to their nearest health center for clinical check-up in the subsequent three months +2 months. Treatment was randomly assigned using computer-generated random numbers. The statistical significance of differences between the two study arms was assessed using chi-square and t-tests for categorical and quantitative data respectively. Risk ratios and 95% confidence intervals were used to assess the effect of the intervention.</p> <p>Results</p> <p>Participants in the intervention arm were 80% more likely to accept (take up) pre-ARV care compared to those in the control arm (RR 1.8, 95% CI 1.4-2.1). No adverse events were reported.</p> <p>Conclusions</p> <p>Provision of post-test counseling by staff trained in basic counseling skills, combined with home visits by community support agents had a significant effect on uptake of pre-ARV care and appears to be a cost-effective way to increase the prerequisites for timely ARV initiation.</p> <p>Trial registration</p> <p>The trial was registered by Current Controlled Trials Ltd C/OBioMed Central Ltd as <a href="http://www.controlled-trials.com/ISRCTN94133652">ISRCTN94133652</a> and received financial support from Sida and logistical support from the European Commission.</p

Civil society leadership in the struggle for AIDS treatment in South Africa and Uganda

Includes abstract.Includes bibliographical references.This thesis is an attempt to theorise and operationalise empirically the notion of ‘civil society leadership’ in Sub-Saharan Africa. ‘AIDS leadership,’ which is associated with the intergovernmental institutions charged with coordinating the global response to HIV/AIDS, is both under-theorised and highly context-specific. In this study I therefore opt for an inclusive framework that draws on a range of approaches, including the literature on ‘leadership’, institutions, social movements and the ‘network’ perspective on civil society mobilisation. This framework is employed in rich and detailed empirical descriptions (‘thick description’) of civil society mobilisation around AIDS, including contentious AIDS activism, in the key case studies of South Africa and Uganda. South Africa and Uganda are widely considered key examples of poor and good leadership (from national political leaders) respectively, while the Treatment Action Campaign (TAC) and The AIDS Support Organisation (TASO) are both seen as highly effective civil society movements. These descriptions emphasise ‘transnational networks of influence’ in which civil society leaders participated (and at times actively constructed) in order to mobilise both symbolic and material resources aimed at exerting influence at the transnational, national and local levels

Civil society and the state in Uganda’s AIDS response

This paper investigates state-civil society relations in the Ugandan AIDS response through a critical exploration of the history of Uganda’s ‘multi-sectoral’ and ‘partnership’ approaches, particularly as it pertains to The AIDS Support Organisation (TASO). It finds that the Ugandan government’s reputation for successful prevention campaigns is not necessarily deserved, and that the effectiveness of civil society is limited by an authoritarian political culture. Despite these limitations, however, state-civil society partnership did contribute to the emergence of a relatively effective coalition for action against HIV/AIDS. Donors were essential in encouraging the emergence of this coalition, but have also inadvertently undermined the emergence of strong and independent civil society voices able to hold the Ugandan state accountable

Gender and primary schooling in Uganda Partnership for strategic resource planning for girls' education in Africa

SIGLEAvailable from British Library Document Supply Centre-DSC:7762.3527(42) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Gender and primary schooling in Uganda Partnership for strategic resource planning for girls' education in Africa

SIGLEAvailable from British Library Document Supply Centre-DSC:7762.3527(42) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Geology and stratigraphy of the south-eastern Lake Edward basin (Petroleum Exploration Area 4B), Albertine Rift Valley, Uganda

<p>The Lake Edward basin lies within the Albertine Rift Valley of Uganda and the Democratic Republic of Congo which forms the northern end of the western arm of the East African Rift System. It is a frontier petroleum prospective area, which, at the outset of this study, had no exploration wells drilled within it or any deep reflection seismic surveys. There have been some previous studies in the basin, but none produced a geological map subdividing the onshore rift-fill sediments or established a workable stratigraphic framework for them. Between 2007 and 2010, Dominion Uganda Ltd., in collaboration with Trinity College Dublin and the Petroleum Exploration and Production Department of the Ministry of Energy, Uganda, undertook a geological mapping survey of the south-eastern onshore part of the basin, known as petroleum ‘Exploration Area 4B’ (EA4B). Five rift sediment formations were identified and mapped across the area to produce a new geological map of EA4B. Palynological analyses suggest that all exposed rift sediments are (Late to Mid) Pleistocene–Holocene. EA4B is dominated by a north-east to south-west trending fault zone which underwent significant extension within the last 130,000 years to produce a trough, or sub-basin, to the south-east against the rift margin. This trough subsequently filled, initially with ponded swamp clays, followed by coarse fluvial and alluvial clastics. There is field evidence for minor inversion and ‘pop-up’ structures along some footwall crests, suggesting that the neotectonic phase is compressional or transpressional, and this has caused stream rejuvenation and incision.</p