Background And Objectives: Despite a well-established universal HIV diagnosis and treatment program, Botswana continues to face a high HIV prevalence, in large part due to persistent stigma, which particularly affects pregnant women and interferes with healthcare engagement. Tackling stigma as a fundamental cause of HIV disparities is an important but understudied aspect of current HIV interventions. Our multinational and multicultural team used a theory-driven, multi-stage iterative process to develop measures and interventions to first identify and then target the most culturally-salient aspects of stigma for mothers living with HIV in Botswana.
View Article and Find Full Text PDFWe conducted a pilot trial of an intervention targeting intersectional stigma related to being pregnant and living with HIV while promoting capabilities for achieving 'respected motherhood' ('what matters most') in Botswana. A pragmatic design allocated participants to the intervention (N = 44) group and the treatment-as-usual (N = 15) group. An intent-to-treat, difference-in-difference analysis found the intervention group had significant decreases in HIV stigma (d = - 1.
View Article and Find Full Text PDFTo explore whether beneficial health care policies, when implemented in the context of gender inequality, yield unintended structural consequences that stigmatize and ostracize women with HIV from "what matters most" in local culture. We conducted 46 in-depth interviews and 5 focus groups (38 individuals) with men and women living with and without HIV in Gaborone, Botswana, in 2017. Cultural imperatives to bear children bring pregnant women into contact with free antenatal services including routine HIV testing, where their HIV status is discovered before their male partners'.
View Article and Find Full Text PDFMental and substance use disorders are a leading cause of disability worldwide. Despite this, there is a paucity of mental health research in low- and middle-income countries, especially in sub-Saharan Africa. We carried out a semi-systematic scoping review to determine the extent of mental health research in Botswana.
View Article and Find Full Text PDFBackground: With high rates of HIV and multiple vulnerable subgroups across diverse settings, there is a need for culturally based, HIV stigma reduction interventions. Pregnant women who are living with HIV are especially in need of services to protect not only their own but also their children's lives. Uptake of HIV services worldwide is hindered by stigma towards persons living with HIV/AIDS.
View Article and Find Full Text PDFCannabis use disorder (CUD) poses major clinical and public health concerns globally. It is a growing problem among the youth in Botswana, yet little research has been done on this subject. The present study hoped to address this gap in knowledge by determining the prevalence and associated factors of CUD among first-year university students in Botswana.
View Article and Find Full Text PDFMental illness is a common comorbidity of HIV and complicates treatment. In Botswana, stigma impedes treatment of mental illness. We examined explanatory beliefs about mental illness, stigma, and interactions between HIV and mental illness among 42 adults, from HIV clinic and community settings, via thematic analysis of interviews.
View Article and Find Full Text PDFBackground: Substance use amongst university students is a recognized problem worldwide. Few studies have been carried out in this group in Botswana. These studies have been mostly limited to the use of alcohol and tobacco.
View Article and Find Full Text PDFWe examined HIV prevalence among patients 18-49 year olds admitted to a psychiatric hospital in Botswana in 2011 and 2012. The retrospective study analyzed females (F) and males (M) separately, comparing proportions with Chi square test and continuous variables with Wilcoxon rank-sum test, assessing significance at the 5% level. HIV seroprevalence among hospitalized psychiatric patients was much more common among females (53%) compared with males (19%) (p < 0.
View Article and Find Full Text PDFBackground: Tobacco use among mentally ill patients is approximately two to three times higher than that in the general population. Withdrawal from tobacco is a common occurrence and many authors have described various symptoms of nicotine withdrawal. Dyskinesia, however, has not been reported as one of the symptoms of nicotine withdrawal in adolescents without any psychopathology or medical illness.
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