Publications by authors named "Nafisa Wara"
Purpose Of Review: Recent research on efficacy and safety of long-acting preexposure prophylaxis (PrEP) holds the promise to transform HIV prevention in high HIV burden settings. We review emerging findings regarding early end-user acceptability of long-acting PrEP modalities, feasibility of integrating long-acting PrEP into health systems, and considerations regarding drug resistance and cost.
Recent Findings: Long-acting PrEP, particularly injectables, was found to be highly acceptable among individuals across key populations in high HIV burden settings.
Background: There are few data on tenofovir-diphosphate (TFV-DP) concentrations in pregnant and postpartum women on Tenofovir Disoproxil Fumarate-Emtricitabine (TDF-FTC) or Tenofovir Alafenamide-Emtricitabine (TAF-FTC).
Methods: Eligible pregnant women were randomized to TDF-FTC or TAF-FTC and followed for 16 weeks (8-weeks pregnant, 8-weeks postpartum) with weekly collection of dried blood spot (DBS) and 4-weekly peripheral blood mononuclear cells (PBMC). PrEP dosing was observed daily via asynchronous videos sent via cell phone.
Article Synopsis
- Intimate partner violence (IPV) is a big problem for pregnant women in South Africa and can harm both the mothers and their babies.
- The study looked at the reasons behind IPV during pregnancy and how it connects with things like alcohol use and the risk of getting HIV.
- Women prefer using oral PrEP for HIV prevention because it helps them feel in control, but many face challenges in getting support due to fear of being judged by others.
Introduction: Long-acting pre-exposure prophylaxis (PrEP) options could overcome barriers to oral PrEP persistence during pregnancy and postpartum. We evaluated long-acting PrEP preferences among oral PrEP-experienced pregnant and postpartum women in South Africa and Kenya, countries with high PrEP coverage with pending regulatory approvals for long-acting injectable cabotegravir and the dapivirine vaginal ring (approved in South Africa, under review in Kenya).
Methods: From September 2021 to February 2022, we surveyed pregnant and postpartum women enrolled in oral PrEP studies in South Africa and Kenya.
Article Synopsis
- * Key concerns among participants included fears about running out of food, potential COVID-19 infection, and worries about job loss, with 70% expressing new worries about ART access.
- * Mental health scores showed a significant decline during the pandemic, highlighting the importance of addressing both economic and psychological challenges in healthcare delivery systems.
Article Synopsis
- A study in South Africa assessed COVID-19 vaccine acceptance among people living with HIV (PLWH), examining their willingness and reasons for hesitancy.
- Out of 213 participants, 57% were willing to get vaccinated, while 21% expressed refusal, with fear of side effects being the main concern.
- Factors such as older age were linked to higher willingness, while medical mistrust and reliance on social media for information were linked to lower acceptance.
Article Synopsis
- People living with HIV (PLWH) in South Africa were assessed for their willingness to accept COVID-19 vaccination, highlighting the importance of vaccinating this vulnerable population due to potential poorer health outcomes with COVID-19.
- A study involving 213 participants revealed that 57% were willing to get vaccinated, while 22% were unsure and 21% declined, with fears about side effects being the most common concern.
- Factors influencing vaccination willingness included increased age (positively correlated) and higher medical mistrust or reliance on social media for COVID-19 information (negatively correlated).
We used the Practical, Robust Implementation and Sustainability Model to evaluate implementation of South Africa's Central Chronic Medicine Dispensing and Distribution (CCMDD) program, a differentiated service delivery program which allows clinically stable HIV-positive patients to receive antiretroviral therapy refills at clinic- or community-based pick-up points. Across ten clinics, we conducted 109 semi-structured interviews with stakeholders (pick-up point staff, CCMDD service providers and administrators) and 16 focus groups with 138 patients. Participants had highly favorable attitudes and said CCMDD decreased stigma concerns.
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- The South African CCMDD program allows individuals living with HIV to collect their medication from various community or clinic locations, aiming to improve convenience and reduce clinic congestion.
- A study analyzed factors affecting the choice of community vs. clinic pick-up points, surveying over 1500 eligible adults in KwaZulu-Natal, focusing on aspects like age, employment, self-efficacy, and perceived barriers.
- Results showed that younger individuals, those employed full-time, and those with higher self-efficacy were more likely to utilize community pick-up points, driven by the convenience of location and hours while also facing challenges related to clinic follow-up after missed pickups.
Background: South Africa faces a high burden of unmet contraceptive need, particularly among adolescent girls and young women. Providing contraception in community-based venues may overcome barriers to contraceptive access. Our objective was to explore the potential impact of the social environment and stylist-client interactions on perceived accessibility of contraceptives within hair salons.
View Article and Find Full Text PDFWe evaluated COVID-19 stigma and medical mistrust among people living with HIV in South Africa. We conducted telephone interviews with participants in a prospective study of a decentralized antiretroviral therapy program. Scales assessing medical mistrust, conspiracy beliefs, anticipated and internalized stigma, and stereotypes specific to COVID-19 were adapted primarily from the HIV literature, with higher scores indicating more stigma or mistrust.
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