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Family planning services during the first wave of COVID-19 in four West African countries: Lessons from a study
No full textGlobal Healthcare Provider Training Package: Dapivirine Vaginal Ring (PrEP Ring)
Get PDFThe development of the PrEP Ring was a response to the reality that women remain more likely to acquire HIV than men. HIV is one of the leading causes of death among women ages 15–49 worldwide. HIV incidence is particularly high among young women: in the age range 15–24 years, they are twice as likely to acquire HIV as men of their age, accounting for nearly 25% of new adult infections in sub-Saharan Africa. Biological, economic and sociocultural factors all play a role in increasing women’s chances of acquiring HIV and manifest in practices such as early sexual debut, early marriage, intergenerational sex and concurrent partnerships
Gender gaps in cognitive and noncognitive skills among adolescents in India
No full textGender gaps in skills exist around the world but differ remarkably among countries. This paper uses a unique data set with more than 20,000 adolescents in rural India to explore gender gaps in cognitive and noncognitive skills. We find that boys have considerable advantages over girls on several indicators of cognitive and noncognitive skills that remains robust to a wide range of controls and specification choices. We also examine the correlates of cognitive and noncognitive outcomes, paying close attention to socioeconomic status (SES) and pro-female gender attitudes. We find a steep positive gradient in SES as well as for pro-female gender attitudes, with stronger associations between the SES gradient and skills. Further, high socioeconomic status and more pro-female gender attitudes are both strongly correlated with reducing the gender gap in cognitive and noncognitive outcomes
Results of a phase 1, randomized, placebo controlled first-in-human trial of griffithsin formulated in a carrageenan vaginal gel
No full textHIV pre-exposure prophylaxis (PrEP) is dominated by clinical therapeutic antiretroviral (ARV) drugs. Griffithsin (GRFT) is a non-ARV lectin with potent anti-HIV activity. GRFT\u27s preclinical safety, lack of systemic absorption after vaginal administration in animal studies, and lack of cross-resistance with existing ARV drugs prompted its development for topical HIV PrEP. We investigated safety, pharmacokinetics (PK), pharmacodynamics (PD), and immunogenicity of PC-6500 (0.1% GRFT in a carrageenan (CG) gel) in healthy women after vaginal administration. This randomized, placebo-controlled, parallel group, double-blind first-in-human phase 1 study enrolled healthy, HIV-negative, non-pregnant women aged 24-45 years. In the open label period, all participants (n = 7) received single dose of PC- 6500. In the randomized period, participants (n = 13) were instructed to self-administer 14 doses of PC-6500 or its matching CG placebo (PC-535) once daily for 14 days. The primary outcomes were safety and PK after single dose, and then after 14 days of dosing. Exploratory outcomes were GRFT concentrations in cervicovaginal fluids, PD, inflammatory mediators and gene expression in ectocervical biopsies. This trial is registered with ClinicalTrials. gov, number NCT02875119. No significant adverse events were recorded in clinical or laboratory results or histopathological evaluations in cervicovaginal mucosa, and no anti-drug (GRFT) antibodies were detected in serum. No cervicovaginal proinflammatory responses and no changes in the ectocervical transcriptome were evident. Decreased levels of proinflammatory chemokines (CXCL8, CCL5 and CCL20) were observed. GRFT was not detected in plasma. GRFT and GRFT/CG in cervicovaginal lavage samples inhibited HIV and HPV, respectively, in vitro in a dose-dependent fashion. These data suggest GRFT formulated in a CG gel is a safe and promising on-demand multipurpose prevention technology product that warrants further investigation
Gendered effects of COVID-19 school closures: Pakistan case study
Get PDFThis brief summarizes a case study conducted to assess the gendered impacts of COVID-19 school closures on adolescent girls and boys in three districts in the province of Punjab in Pakistan. Data as well as discussions and interviews with adolescents, teachers, and parents shed light on difficulties in accessing and adjusting to remote learning, learning loss, deterioration of behaviors and health, and other effects. Based on these findings and further reflections by stakeholders on the successes and gaps of mitigation measures, the case study proposes recommendations for improved teacher training, digital access, alternative learning options, and a gendered focus in interventions
Determining the most significant changes on intergenerational communication and young people’s family planning and reproductive health outcomes: Qualitative evaluation of the Merci Mon Héros media campaign in Niger and Côte d’Ivoire
Get PDFMerci Mon Héros (MMH) is a mixed media campaign that catalyzes young people as co-leaders to improve intergenerational communication and young people’s family planning (FP) and reproductive health (RH) outcomes. Breakthrough ACTION co-facilitated and codeveloped this youth-led campaign in francophone African countries while the Breakthrough RESEARCH project was tasked with evaluating the MMH campaign to determine the most significant changes in the communities exposed to the mixed media campaign in Niger and Côte d’Ivoire. Using the qualitative methodology of Most Significant Change, participants shared personal narratives during focus group discussions in each country. The diverse stories collected in both countries demonstrate how the MMH campaign can create an enabling environment for young people and adults to begin communicating about FP/RH and access the information, support, and services they need. While there is still a long way to go to eradicate taboos around FP/RH for adolescents and dispel myths that access to information promotes promiscuity, this evaluation found that some youth and adults exposed to the MMH campaign are contributing to a more enabling environment for others around them to talk about and access FP/RH information and quality services
Towards safer recruitment of Ethiopian women into domestic work abroad: Early findings from the Meneshachin ‘Our Departure’ qualitative study
Get PDFThis report presents preliminary findings from the first phase of data collection of the Meneshachin ‘Our Departure’ qualitative study conducted by the London School of Hygiene and Tropical Medicine in collaboration with the Population Council in Ethiopia and the Freedom Fund, with support and funding from the U.S. Department of State. The study aims to inform the development of feasible, responsible recruitment measures that could reduce the risk of labor exploitation and trafficking experienced by Ethiopian migrant women seeking domestic work abroad. The research focuses on the role of different actors in arranging Ethiopian women’s migration to the Middle East and Gulf States for the purpose of domestic labor, and how these actors’ activities exacerbate or mitigate risk of harm. The report concludes with a discussion of challenges and opportunities to promote safer recruitment practices throughout the migration cycle
Hearing from men living with HIV: Experiences with HIV testing, treatment, and viral load suppression in four high-prevalence countries in sub-Saharan Africa
No full textEngaging men in HIV services remains a challenge across sub-Saharan Africa. There is a critical need to better understand facilitators of men\u27s successful engagement with HIV services and assess if there are similarities across contexts. We conducted in-depth interviews and focus group discussions with 92 men living with HIV (MLHIV) across Malawi, Uganda, South Africa, and Eswatini, most of whom had been diagnosed with HIV within the last 5 years. We coded interviews for themes using a constant-comparative approach. We contextualized our findings within a socioecological framework. HIV testing was primarily motivated by illness (individual level), though illness was sometimes accompanied by prompting and support from healthcare providers and/or intimate partners. Once diagnosed, nearly all participants reported immediate linkage to care, initiation of antiretroviral therapy (ART), and subsequent ART adherence. ART initiation and adherence were facilitated by men\u27s sense of agency and ownership over their health (individual level), social support from intimate partners, friends, and family (interpersonal/network level), supportive-directive counseling from healthcare providers (institutional/health systems level), and male-friendly services, i.e., rapid, respectful, private (institutional/health systems level). Health literacy regarding viral suppression (individual level), strengthened by patient-provider communication (institutional/health systems level), was highest in Uganda, where most men could discuss viral load testing experiences, report their viral load status (most reported suppressed), and demonstrate an understanding of treatment as prevention. Elsewhere, few participants understood what viral load suppression was and even fewer knew their viral load status. Our findings reveal socioecological-level facilitators of men\u27s progress across the HIV-care continuum. Programs may want to leverage facilitators of ART initiation and adherence that span socioecological levels—e.g., healthcare ownership and agency, social support, supportive-directive counseling—and apply them to each end of the continuum to encourage early HIV testing/diagnosis and improve health literacy to help men understand and achieve viral load suppression
Planning for injecting drug use as a means to prevent risky injection behavior
No full textObjective: People who inject drugs (PWIDs) are at risk of exposure to blood borne pathogens. India has a large PWID population and the highest HIV transmission is among PWIDs. Interventions to prevent risky injection is constantly tested by the scientific community and innovations are required in this area. Methods: 3748 male PWIDs were recruited into a longitudinal study. 2509 PWIDs who participated in the end of study survey, also responded to multiple open ended questions asked by the interviewers. The qualitative interviews were analyzed focusing on identifying themes and relationship among themes. Results: 35.6% of the cohort had engaged in risky injection at least once. Although the project activities promoted safe injection practices among majority of the study participants; 35% is a substantial population at risk. Gaining knowledge about blood borne pathogen transmission, motivated participants to be careful about not sharing injection or paraphernalia. The belief that friends are safe made many share among themselves. Not prepared when the withdrawal set in was the main reason for sharing injection. Conclusion: The project intervention had stimulating effect on the PWIDs and they tried to stop injection and follow safe injection practices. However, a failure at least once is an exposure to blood borne pathogens. Hence teaching PWIDs to plan for their injection practice and keeping materials ready at hand is important
Biruh Tesfa ( Bright Future )
No full textBiruh Tesfa is a program that reduces the social isolation of vulnerable girls in urban Ethiopia and provides them with information and services to help prevent sexual exploitation and abuse