Mortality in HIV and tuberculosis patients following implementation of integrated HIV-TB treatment: Results from an open-label cluster-randomized trial.

Background: HIV-TB treatment integration reduces mortality. Operational implementation of integrated services is challenging. This study assessed the impact of quality improvement (QI) for HIV-TB integration on mortality within primary healthcare (PHC) clinics in South Africa.

A Quality Improvement Intervention to Inform Scale-Up of Integrated HIV-TB Services: Lessons Learned From KwaZulu-Natal, South Africa.

Introduction: In South Africa, mortality rates among HIV-TB coinfected patients are among the highest in the world. The key to reducing mortality is integrating HIV-TB services, however, a generalizable implementation method and package of tested change ideas to guide the scale-up of integrated HIV-TB services are unavailable. We describe the implementation of a quality improvement (QI) intervention, health systems' weaknesses, change ideas, and lessons learned in improving integrated HIV-TB services.

Impact of a provider job aid intervention on injectable contraceptive continuation in South Africa.

Arriving late for scheduled contraceptive reinjections is common in many countries and contributes to discontinuation when providers are unsure how to manage such clients. A clinic-randomized cohort and cross-sectional study with more than 5,000 clients using injectable contraceptives was conducted in the Eastern Cape province of South Africa to test the effectiveness of a provider job aid for managing late-returning clients and promoting continued use of the method. A marginally significant difference in reinjection rates between intervention and control groups was found for those up to two weeks late, and reanalysis excluding one clinic that experienced stockout issues revealed a significant difference.

Survey of knowledge, attitudes and practices surrounding the intrauterine device in South Africa.

Background: The Copper T intrauterine device (IUD) is a safe, effective, reversible contraceptive that is used widely worldwide but little in South Africa. This study assesses the knowledge, attitudes and practices of potential IUD users and health care providers to inform strategies for expanding IUD use in South Africa.

Study Design: A descriptive, cross-sectional survey was conducted among 205 clients and 32 health care providers at 12 public sector clinics in two provinces.

Language choice and sexual communication among Xhosa speakers in Cape Town, South Africa: implications for HIV prevention message development.

Communicating about sex is a vital component of human immunodeficiency virus (HIV) prevention and influences how HIV educators convey messages to communities and how couples negotiate safer sex practices. However, sexual communication inevitably confronts culturally based behavioral guidelines and linguistic taboos unique to diverse social contexts. The HIV interventionist needs to identify the appropriate language for sexual communication given the participants and the message.

Community norms for HIV risk behaviors among men in a South African township.

We investigated alcohol-related sexual risk behavior from the perspective of social norms theory. Adults (N = 895, 62% men) residing in a South African township completed street-intercept surveys that assessed risk and protective behaviors (e.g.

Knowledge and use of emergency contraception among women in the Western Cape province of South Africa: a cross-sectional study.

Background: Emergency contraception (EC) is widely available free of charge at public sector clinics in South Africa. At the same time, rates of teenage and unintended pregnancy in South Africa remain high, and there are few data on knowledge of EC in the general population in South Africa, as in other resource-limited settings.

Methods: We conducted a cross-sectional, interviewer-administered survey among 831 sexually active women at 26 randomly selected public sector clinics in the Western Cape province.

Timeliness of contraceptive reinjections in South Africa and its relation to unintentional discontinuation.

Context: Research examining hormonal injectable contraceptive continuation has focused on clients' intentional discontinuation. Little attention, however, has been paid to unintentional discontinuation due to providers' management of clients who would like to continue use but arrive late for their scheduled reinjections.

Methods: A cross-sectional survey of 1,042 continuing injectable clients at 10 public clinics was conducted in South Africa's Western and Eastern Cape provinces.