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  • 1
    Online Resource
    Online Resource
    Correlates of prevalent HIV infection among adults and adolescents in the Kisumu incidence cohort study, Kisumu, Kenya
    SAGE Publications ; 2015
    In:  International Journal of STD & AIDS Vol. 26, No. 13 ( 2015-11), p. 929-940
    Details
    In: International Journal of STD & AIDS, SAGE Publications, Vol. 26, No. 13 ( 2015-11), p. 929-940
    Abstract: We estimated HIV prevalence and identified correlates of HIV infection among 1106 men and women aged 16–34 years residing in Kisumu, Kenya. Demographic, sexual, and other behavioural data were collected using audio computer-assisted self-interview in conjunction with a medical examination, real-time parallel rapid HIV testing, and laboratory testing for pregnancy, gonorrhoea, chlamydia, syphilis, and herpes simplex virus type 2. Multivariate logistic regression was used to identify variables associated with prevalent HIV infection by gender. Overall HIV prevalence was 12.1%. HIV prevalence among women (17.1%) was approximately two-and-one-half times the prevalence among men (6.6%). Odds of HIV infection in men increased with age (aOR associated with one-year increase in age = 1.21, CI = 1.07–1.35) and were greater among those who were uncircumcised (aOR = 4.42, CI = 1.41–13.89) and those who had an herpes simplex virus type 2-positive (aOR = 3.13, CI = 1.12–8.73) test result. Odds of prevalent HIV infection among women also increased with age (aOR associated with one-year increase in age = 1.16, CI = 1.04–1.29). Women who tested herpes simplex virus type 2 positive had more than three times the odds (aOR = 3.85, CI = 1.38–10.46) of prevalent HIV infection compared with those who tested herpes simplex virus type 2 negative. Tailored sexual health interventions and programs may help mitigate HIV age and gender disparities.
    Type of Medium: Online Resource
    ISSN: 0956-4624 , 1758-1052
    URL: Article
    DOI: 10.1177/0956462414563625
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 2009782-7
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  • 2
    Online Resource
    Online Resource
    Effect of Gender of the Recorded Voice on Responses to Sensitive Sexual Behavior Questions : Use of Audio Computer-Assisted Self-Interview (ACASI) in Kisumu, Kenya
    SAGE Publications ; 2012
    In:  Field Methods Vol. 24, No. 4 ( 2012-11), p. 367-381
    Details
    In: Field Methods, SAGE Publications, Vol. 24, No. 4 ( 2012-11), p. 367-381
    Abstract: Audio computer-assisted self-interview (ACASI) has been shown to reduce interviewer and social desirability bias related to sensitive questions, which can be especially important for studies of sexual behavior and HIV risk. Baseline demographic and HIV risk data were collected using ACASI for 849 adults aged 18–34 (423 males and 426 females) of unknown or HIV-negative status as part of an HIV-incidence cohort study in Kisumu, Kenya. ACASI questionnaires and possible responses were recorded being read either by a male or female voice in the three most commonly used languages (English, Kiswahili, and Dholuo). Participants were randomly assigned to hear either male or female voice. Dependent variables, including 12 sexual behavior questions, were evaluated using logistic regression. No significant differences in responses to the 12 sensitive questions were found for gender of the recorded voice on ACASI or for the interaction between gender of recorded ACASI voice and respondent gender.
    Type of Medium: Online Resource
    ISSN: 1525-822X , 1552-3969
    URL: Article
    DOI: 10.1177/1525822X11432087
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2012
    detail.hit.zdb_id: 2058705-3
    SSG: 5,1
    SSG: 10
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  • 3
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    Online Resource
    High prevalence of sexually transmitted infections among women screened for a contraceptive intravaginal ring study, Kisumu, Kenya, 2014
    SAGE Publications ; 2018
    In:  International Journal of STD & AIDS Vol. 29, No. 14 ( 2018-12), p. 1390-1399
    Details
    In: International Journal of STD & AIDS, SAGE Publications, Vol. 29, No. 14 ( 2018-12), p. 1390-1399
    Abstract: We assessed prevalence and correlates of bacterial vaginosis (BV) and sexually transmitted infections (STIs) including herpes simplex virus type 2 (HSV-2), gonorrhoea (GC), syphilis (SYP), Chlamydia (CT) and HIV among Kenyan women aged 18–34 years who were screened for a contraceptive intravaginal ring study. Women provided demographic, behavioural and medical information, and underwent medical evaluation, including a pelvic exam. We computed crude and adjusted prevalence ratio (aPR) and 95% confidence interval (CI) using log-binomial regression. Of 463 women screened, 457 provided laboratory specimens and were included in the analysis. The median age was 25 years, interquartile range (21–28), and 68.5% had completed primary or lower education. Overall, 72.2% tested positive for any STI or BV. Point prevalence was 55.6, 38.5, 3.9, 2.0, 4.6, and 14.7% for HSV-2, BV, GC, SYP, CT, and HIV, respectively. Co-infection with HSV-2, BV, and HIV occurred in 28 (6.1%) participants. Having ≥1 STI/BV was associated with younger age at first sex (≤13 versus 17–19 years, aPR=1.27, 95% CI 1.07–1.51), history of exchange sex (aPR = 2.05, 95% CI 1.07–3.92), sexual intercourse in the past seven days (aPR = 1.17, 95% CI 1.01–1.36), and older age (30–34 versus 18–24 years, aPR = 1.26, 95% CI 1.06–1.48). STI/BV diagnosis was less likely for women reporting one lifetime sexual partner compared to women with ≥4 lifetime sexual partners (aPR = 0.70, 95% CI 0.54–0.92). Combination prevention approaches (biomedical, behavioural, social, and structural) tailored to women with diverse risk profiles may help mitigate STI/BV prevalence in this setting.
    Type of Medium: Online Resource
    ISSN: 0956-4624 , 1758-1052
    URL: Article
    DOI: 10.1177/0956462418782810
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2009782-7
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  • 4
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    Online Resource
    Medical pluralism and rationalities for HIV care utilization among discordant couples in Siaya County, rural western Kenya
    SAGE Publications ; 2019
    In:  International Journal of STD & AIDS Vol. 30, No. 9 ( 2019-08), p. 868-874
    Details
    In: International Journal of STD & AIDS, SAGE Publications, Vol. 30, No. 9 ( 2019-08), p. 868-874
    Abstract: Understanding healthcare seeking and utilization of members of discordant couples can help in implementing effective HIV treatment, care, and support. We conducted a qualitative study comprised of in-depth interviews (n = 26) and ten focus group discussions (n = 73) with community members including opinion leaders, healthcare workers, and members of discordant couples. A portion of the latter group had been participants in the HIV Prevention Trials Network (HPTN) 052 study. Themes that emerged from the data were pragmatism and the realities of hospital care, quest for a cure through traditional medicine, and religious dogma. Medical pluralism is practiced by members of discordant couples seeking HIV care through intersections of hospital facility services and traditional and religious therapeutic options. It would be prudent for healthcare policy makers and conventional medical providers to recognize the importance of traditional medicine and religion in the lives of members of HIV discordant couples and make efforts to integrate the positive concepts of both into the couples’ overall health plan.
    Type of Medium: Online Resource
    ISSN: 0956-4624 , 1758-1052
    URL: Article
    DOI: 10.1177/0956462419843691
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2009782-7
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  • 5
    Online Resource
    Online Resource
    Vaccine Beliefs of Parents Who Oppose Compulsory Vaccination
    SAGE Publications ; 2005
    In:  Public Health Reports Vol. 120, No. 3 ( 2005-05), p. 252-258
    Details
    In: Public Health Reports, SAGE Publications, Vol. 120, No. 3 ( 2005-05), p. 252-258
    Abstract: Our objectives were the following: ( 1) to describe the sociodemographic factors, vaccine beliefs, and behaviors that are associated with parental opposition to compulsory vaccination, and ( 2) to determine if the availability of a philosophical exemption in a parent's state of residence is associated with parental opposition to compulsory vaccination. Methods. Data from the 2002 HealthStyles survey were analyzed. Chi-square analysis was used to identify significant associations between belief and behavior questions and opposition to compulsory vaccination for school entry. Multivariate logistic regression was conducted using significant variables from the bivariate analysis to identify independent predictors of opposition to compulsory vaccination among surveyed parents. Results. Of respondents with at least one child aged ⩽18 years living in the household ( n = 1,527), 12% were opposed to compulsory vaccination. Survey results indicate that a parent's belief regarding compulsory vaccination for school entry is significantly associated with beliefs in the safety and utility of vaccines, as well as intention to have the youngest child fully vaccinated. Residence in a state that permits philosophical exemption to vaccination also was significantly associated with a parent's opposition to compulsory vaccination for school entry. Conclusions. Providing basic information to parents regarding vaccines and vaccine-preventable diseases may help reduce opposition to compulsory vaccination by reinforcing the safety and importance of routine childhood vaccinations.
    Type of Medium: Online Resource
    ISSN: 0033-3549 , 1468-2877
    URL: Article
    DOI: 10.1177/003335490512000306
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2005
    detail.hit.zdb_id: 2017700-8
    SSG: 20,1
    SSG: 27
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  • 6
    Online Resource
    Online Resource
    Medical Risks and Benefits of Newborn Male Circumcision in the United States : Physician Perspectives
    SAGE Publications ; 2015
    In:  Journal of the International Association of Providers of AIDS Care (JIAPAC) Vol. 14, No. 1 ( 2015-01), p. 33-39
    Details
    In: Journal of the International Association of Providers of AIDS Care (JIAPAC), SAGE Publications, Vol. 14, No. 1 ( 2015-01), p. 33-39
    Abstract: In 2012, the American Academy of Pediatrics (AAP) and the American Congress of Obstetricians and Gynecologists (ACOG) published recommendations that physicians should discuss with parents the benefits and risks of newborn male circumcision. Our objective was to assess physicians’ perspectives of newborn male circumcision. Methods: A self-administered, cross-sectional electronic survey of US physicians was conducted in 2008 (N = 1500). Results: Approximately one-third (33.2%) of the respondents reported that their current perspective was that the medical benefits outweigh the risks associated with newborn male circumcision and less than one-third (31.1%) reported they would recommend the procedure when counseling parents. Conclusions: In 2008, only about one-third of the physicians surveyed thought that the benefits of male circumcision outweighed the risks and recommended it to parents of newborn sons. These attitudes may be relevant to the declining circumcision rates in the United States. Repeat surveys may be useful, given the new AAP and ACOG recommendations.
    Type of Medium: Online Resource
    ISSN: 2325-9582 , 2325-9582
    URL: Article
    DOI: 10.1177/2325957414535975
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 2709037-1
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  • 7
    Online Resource
    Online Resource
    Measles Outbreak Associated with a Church Congregation: A Study of Immunization Attitudes of Congregation Members
    SAGE Publications ; 2008
    In:  Public Health Reports Vol. 123, No. 2 ( 2008-03), p. 126-134
    Details
    In: Public Health Reports, SAGE Publications, Vol. 123, No. 2 ( 2008-03), p. 126-134
    Abstract: Although measles has not been endemic in the U.S. since 1997 due to high vaccination coverage, recent U.S. measles outbreaks have been associated with individuals and groups who have refused vaccination for philosophical, cultural, or religious reasons. One such outbreak occurred in Indiana among a group of church members in May and June of 2005. Our objectives were to: ( 1) determine attitudes and beliefs of church leaders and members regarding vaccinations and the outbreak experience, ( 2) describe reasons for vaccine acceptance and nonacceptance, and ( 3) assess the feasibility of a knowledge and attitudes study in the context of a vaccine-preventable disease outbreak. Methods. We conducted a focus group with church leaders and families and held 12 structured household interviews with church members directly and indirectly involved in the outbreaks. Results. A combination of safety concerns, personal experience, and religious beliefs contributed to vaccination refusal among a subgroup of church members. While the experience with measles disease did not necessarily translate into a more positive perception of vaccines, most families that refused vaccination would accept some future vaccines under unique circumstances, such as disease presence in the community or if vaccination could be delayed until a child was older. Conclusions. Lessons learned from this outbreak experience can inform future outbreak investigations elsewhere. Maintaining open communication with parents who refuse immunizations, as well as working with their trusted social networks, can help public health professionals facilitate alternative means of disease control during a vaccine-preventable disease outbreak in the community.
    Type of Medium: Online Resource
    ISSN: 0033-3549 , 1468-2877
    URL: Article
    DOI: 10.1177/003335490812300205
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2008
    detail.hit.zdb_id: 2017700-8
    SSG: 20,1
    SSG: 27
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  • 8
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    Online Resource
    Participant satisfaction with clinical trial experience and post-trial transitioning to HIV care in Kenya
    SAGE Publications ; 2019
    In:  International Journal of STD & AIDS Vol. 30, No. 1 ( 2019-01), p. 12-19
    Details
    In: International Journal of STD & AIDS, SAGE Publications, Vol. 30, No. 1 ( 2019-01), p. 12-19
    Abstract: We conducted an exploratory analysis of former HIV Prevention Trials Network 052 (HPTN 052) clinical trial participants in 2016 to assess their (1) satisfaction with the HPTN 052 clinical trial care and treatment, and reasons for joining the trial; and (2) perspectives about the post-trial transition to public HIV care centers. Quantitative data showed that, of the 70 survey participants, 94.3% (n = 66) reported being very satisfied with the care and treatment they received while participating in the clinical trial and 51.4% (n = 36) reported they joined the study because they would receive information to improve their own or their partner’s health. Qualitative data (five in-depth interviews and two focus group discussions) analysis revealed the following themes: transition experiences; perceived superior clinical trial care; study benefits not offered at public HIV care centers; and the public HIV care centers’ indifference to the uninfected partner. For some HPTN 052 participants, transition to HIV care clinics was disappointing. Clinical trial investigators and local Institutional Review Boards should consider the need for safeguards and oversight of post-trial health care for trial participants after the trial ends, especially in resource-constrained settings, to avoid negative health outcomes.
    Type of Medium: Online Resource
    ISSN: 0956-4624 , 1758-1052
    URL: Article
    DOI: 10.1177/0956462418791946
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2009782-7
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  • 9
    Online Resource
    Online Resource
    Investigation of HIV Incidence Rates in a High-Risk, High-Prevalence Kenyan Population : Potential Lessons for Intervention Trials and Programmatic Strategies
    SAGE Publications ; 2016
    In:  Journal of the International Association of Providers of AIDS Care (JIAPAC) Vol. 15, No. 1 ( 2016-01), p. 42-50
    Details
    In: Journal of the International Association of Providers of AIDS Care (JIAPAC), SAGE Publications, Vol. 15, No. 1 ( 2016-01), p. 42-50
    Abstract: Cost-effective HIV prevention programs should target persons at high risk of HIV acquisition. We conducted an observational HIV incidence cohort study in Kisumu, Kenya, where HIV prevalence is triple that of the national rate. We used referral and venue-sampling approaches to enroll HIV-negative persons for a 12-month observational cohort, August 2010 to September 2011, collected data using computer-assisted interviews, and performed HIV testing quarterly. Among 1292 eligible persons, 648 (50%) were excluded for HIV positivity and other reasons. Of the 644 enrollees, 52% were women who were significantly older than men ( P 〈 .01). In all, 7 persons seroconverted (incidence rate [IR] per 100 person-years = 1.11; 95% confidence interval [CI] 0.45-2.30), 6 were women; 5 (IR = 3.14; 95% CI 1.02-7.34) of whom were ≤25 years. Most new infections occurred in young women, an observation consistent with other findings in sub-Saharan Africa that women aged ≤25 years are an important population for HIV intervention trials in Africa.
    Type of Medium: Online Resource
    ISSN: 2325-9582 , 2325-9582
    URL: Article
    DOI: 10.1177/2325957413511667
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2709037-1
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