Background While links between intimate-partner violence (IPV) and HIV risk have been established, less is known about perpetrated by people other than intimate partners. In addition, much of the research on IPV has conducted with adults, while relatively little experienced adolescent girls young women (AGYW). We examined experiences sexual associated mental health among AGYW in Kenya Zambia. Methods Using cross-sectional surveys aged 15–24 years, we assessed experience partner respondents...

To stem the HIV epidemic among adolescent girls and young women (AGYW, 15–24 years), prevention programs need to reach AGYW who are most at risk. We examine whether individual- household-level factors could be used define vulnerability for AGYW. surveyed out-of-school in urban peri-urban Kenya (N = 1014), Zambia 846), rural Malawi 1654) from October 2016 2017. LCA identified classes based on respondent characteristics, attitudes knowledge, household characteristics. Multilevel regressions...

Since the beginning of 21st century, development assistance for HIV/AIDS has increasingly been provided through Global Health Initiatives, specifically United States Presidential Emergency Plan AIDS Relief, Fund to Fight HIV, TB and Malaria World Bank Multi-country Programme. Zambia, like many countries heavily affected by in southern Africa, also faces a shortage human resources health. The country receives significant amounts funding from GHIs large-scale provision antiretroviral treatment...

Introduction Despite the relatively effective roll‐out of free life‐prolonging antiretroviral therapy (ART) in public sector clinics Zambia since 2005, and proven efficacy ART, some people living with HIV (PLHIV) are abandoning treatment. Drawing on a wider ethnographic study predominantly low‐income, high‐density residential area Lusaka, this paper reports reasons why PLHIV opted to discontinue their Methods Opened‐ended, in‐depth interviews were held who had stopped ART (n = 25), clinic...

Objectives In Zambia, despite a relatively liberal legal framework, there remains substantial burden of unsafe abortion. Many women do not use skilled providers in well-equipped setting, even where these are available. The aim this study was to describe women's knowledge the law relating abortion and attitudes towards Zambia. Setting Community-based survey Central, Copperbelt Lusaka provinces. Participants 1484 reproductive age (15–44 years). Primary secondary outcome measures Correct...

Couple HIV testing has been recognized as critical to increase uptake of testing, facilitate disclosure status marital partner, improve access treatment, care and support, promote safe sex. The Zambia national protocol on integrated prevention mother-to-child transmission (PMTCT) allows for the provision couple in antenatal clinics. This paper examines experiences provider-initiated at a public clinic discusses policy practical lessons. Using narrative approach, open-ended in-depth...

Gauging community responses to the WHO 2015 recommendation provide antiretroviral treatment (ART) all people living with HIV (PLHIV) is critical. There limited qualitative evidence on acceptability of this Universal Test and Treat (UTT) strategy or understanding impact ART reducing transmission, promoted as Treatment Prevention (TasP). This article explores early UTT TasP in 21 urban communities South Africa Zambia 2013 before a randomized trial combination prevention-HPTN 071 (PopART). It...

Recently, a growing body of literature has established that disrespect and abuse during delivery is prevalent around the world. This complex issue not been well studied through lens behavioral science, which could shed light on psychological dimensions health worker behavior how their micro-level context may be triggering abuse. Our research focuses drivers in Zambia to develop solutions with workers women improve experience care delivery.A qualitative study based design methodology was...

This paper explores the effect of social relations and gender-based conflicts on uptake HIV testing in South Central provinces Zambia. We conducted a community-based cross-sectional study 1716 randomly selected individuals. Associations were examined using mixed-effect multivariable logistic regression. A total 264 men (64%) 268 women (56%) had never tested for HIV. The strongest determinants not being disruptive couple relationships (OR = 2.48 95% CI 1.00–6.19); tolerance to violence 2.10...

Across Sub-Saharan Africa, the roll-out of antiretroviral treatment (ART) has contributed to shifting HIV care towards management a chronic health condition. While balance professional and lay tasks in caregiving been significantly altered due changing skills requirements task-shifting initiatives, little attention given effects these changes on workers' motivation existing relations. This paper draws cross-sectional, qualitative study that explored home-based (HBC) light widespread ART...

Disclosure of adolescents' own HIV status by caregivers is not only challenging but low. The reasons for this remain unclear despite efforts to examine and seek understand disclosure patterns or factors that may either facilitate inhibit disclosure. This study explored the enablers, barriers processes adolescents their in Kafue district Zambia.A case method was used caregiver's ability disclose aged 10-15 years. Data collected through in-depth interviews with 30 as well 6 key informants were...

Abstract Introduction Optimizing uptake of pre‐exposure prophylaxis (PrEP) for individuals at risk HIV acquisition has been challenging despite clear scientific evidence and normative guidelines, particularly key populations (KPs) such as men who have sex with (MSM), female workers (FSWs), transgender (TG) people persons inject drugs (PWID). Applying an iterative Programme Science cycle, building on the effective programme coverage framework, we describe approach used by Centre Infectious...

Some people living with HIV (PLHIV) refuse to initiate antiretroviral therapy (ART) despite availability. Between March 2010 and September 2011, using a social ecological framework, we investigated barriers ART initiation in Lusaka, Zambia. In-depth interviews were conducted PLHIV who offered treatment but declined (n=37), staff (n=5), faith healers herbal medicine providers home-based care (n=5). One focus group discussion lay counselors observations the community at an clinic conducted....

Abstract Introduction Zambia is among the countries with highest HIV burden and where youth remain disproportionally affected. Access to testing counselling (HTC) a crucial step ensure reduction of transmission. This study examines changes that occurred between 2007 2018 in access HTC, inequities uptake, determinants HTC uptake youth. Methods We carried out repeated cross-sectional analyses using three Zambian Demographic Health Surveys (2007, 2013–14, 2018). calculated percentage women men...

Objectives To assess temporal shifts in HIV risk factors among adolescent girls (AG, aged 15–19 years) and young women (YW, 20–24 Kenya, Malawi Zambia. Design Prospective cohorts with two time points (Kenya: 2016/2017, 2018; Malawi: 2017, Zambia: 2018) Setting Community-based programming. Participants 1247 AG 389, 371, 487) 1628 YW 347, 883, 398) Intervention Determined, Resilient, Empowered, AIDS-free, Mentored Safe (DREAMS), a multisectoral approach to reduce AGYW’s vulnerability by...

HIV epidemic control requires improving access and uptake of services by key populations (KPs). In Zambia, the behaviors female sex workers (FSWs), men who have with (MSM), people use drugs (PWUD) are criminalized, little information exists about their HIV/STI service use. Using a quality care (QOC) framework, we compared barriers to opportunities for among three KPs. We conducted in-depth interviews focus group discussions 314 KP members between July 2013 September 2015 in eight districts....

This article investigates reasons why children who were considered at risk of HIV not taken for testing by their caregivers. Qualitative and quantitative data collected in Zambia from 2010–11 revealed that twelve percent caregivers stated they had been suspecting an infection a child custody the tested. Fears negative reactions family most often reason child. Experience pre-existing conflicts between couple or within (aOR 1.35, 95% CI 1.00–1.82) observed stigmatisation seropositive one's own...

Objectives: Recent research demonstrates that economic interventions may positively effect HIV risk among adolescent girls and young women (AGYW) in sub-Saharan Africa. Some evidence reveals potential associations between financial decision-making bargaining power sexual relationships. However, this is mixed, nuanced, limited. This paper explores how AGYW Zambia understand agency its on intimate Methods: In-depth qualitative interviews were conducted with 30 females aged 15-24 years residing...

This study explores socio-structural factors that influence uptake of antiretroviral treatment (ART) in Zambia and assess differences between men women. We conducted a case-control nested community- health facility-based survey, September 2010 February 2011. Cases were defined as HIV-positive individuals who, while eligible, never started ART controls who on ART. matched by place residence. performed conditional logistic regression analysis using discrete model stratified sex. Overall,...

Despite the increasingly wider availability of antiretroviral therapy (ART), some people living with HIV (PLHIV) and eligible for treatment have opted to adopt self-care practices thereby risking early AIDS-related mortality.A qualitative study was conducted in urban Zambia gain insights into PLHIV experiences explore implications successful delivery ART care. Between March 2010 September 2011, in-depth interviews were who had dropped out (n=25) those that not initiate medication (n=37)....

Knowledge of HIV status is crucial for prevention and management in marital relationships. Yet some partners people living with decline testing despite knowing the HIV-positive their partners. To date, little research has explored reasons this.An exploratory qualitative study was undertaken Lusaka, Zambia, between March 2010 September 2011, nested within a larger ethnographic study. In-depth interviews were held individuals who knew but never sought (n = 30) service providers public sector...

Abstract Lack of family involvement is barrier to antiretroviral therapy adherence among adolescent girls and young women (AGYW). This study assessed support for AGYW's engagement along the HIV care continuum inform design a family-focused intervention in Lusaka, Zambia. We conducted 16 in-depth interviews four focus group discussions with 40 AGYW living HIV. Three strategies were identified strengthen support. First, emotional instrumental are highly valued by should be further developed or...

Youth-friendly health care delivery models are needed to address the complex needs of adolescent girls and young women (AGYW). The aim this study is explore lived experiences AGYW seeking comprehensive HIV sexual reproductive (SRH) elicit their preferences for integrated services. We conducted in-depth interviews focus group discussions in Lusaka, Zambia among 69 aged 10-20 who were HIV-negative or unknown status 40 16-24 living with HIV. data coded through deductive inductive processes...