Young women in sub-Saharan Africa continue to be disproportionately at risk for HIV. Oral pre-exposure prophylaxis (PrEP) can reduce women's HIV risk when taken daily throughout their "seasons of risk". We used photovoice to describe community views on factors influencing interruptions in PrEP use among young cisgender women in Siaya County, Kenya. Through group discussions, young women taking PrEP and their social network members (female peers, male peers/partners, family, and community members) shared photographs and identified broad social-ecological causes of PrEP interruptions, including: (1) widespread misinformation about PrEP, (2) social pressures from religious communities, (3) health care staff recommendations to interrupt PrEP use, (4) partner rejection of PrEP, (5) changes in women's risk awareness, and (6) a personal desire to occasionally pause daily use. Collectively, participants identified strategies to address these challenges. These findings can inform future programs targeting the broader social-ecological influences on young women's persistent use of PrEP.
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http://dx.doi.org/10.1521/aeap.2023.35.2.141 | DOI Listing |
JMIR Ment Health
January 2025
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
Background: Mental health concerns have become increasingly prevalent; however, care remains inaccessible to many. While digital mental health interventions offer a promising solution, self-help and even coached apps have not fully addressed the challenge. There is now a growing interest in hybrid, or blended, care approaches that use apps as tools to augment, rather than to entirely guide, care.
View Article and Find Full Text PDFN Engl J Med
January 2025
From Médecins Sans Frontières (L.G., F.V.), Sorbonne Université, INSERM Unité 1135, Centre d'Immunologie et des Maladies Infectieuses (L.G.), Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux (L.G.), and Epicentre (M.G., E. Baudin), Paris, and Translational Research on HIV and Endemic and Emerging Infectious Diseases, Montpellier Université de Montpellier, Montpellier, Institut de Recherche pour le Développement, Montpellier, INSERM, Montpellier (M.B.) - all in France; Interactive Development and Research, Singapore (U.K.); McGill University, Epidemiology, Biostatistics, and Occupational Health, Montreal (U.K.); UCSF Center for Tuberculosis (G.E.V., P.N., P.P.J.P.) and the Division of HIV, Infectious Diseases, and Global Medicine (G.E.V.), University of California at San Francisco, San Francisco; the National Scientific Center of Phthisiopulmonology (A.A., E. Berikova) and the Center of Phthisiopulmonology of Almaty Health Department (A.K.), Almaty, and the City Center of Phthisiopulmonology, Astana (Z.D.) - all in Kazakhstan; Médecins Sans Frontières (C.B., I.M.), the Medical Research Council Clinical Trials Unit at University College London (I.M.), and St. George's University of London Institute for Infection and Immunity (S.W.) - all in London; MedStar Health Research Institute, Washington, DC (M.C.); Médecins Sans Frontières, Mumbai (V. Chavan), the Indian Council of Medical Research Headquarters-New Delhi, New Delhi (S. Panda), and the Indian Council of Medical Research-National AIDS Research Institute, Pune (S. Patil) - all in India; the Centre for Infectious Disease Epidemiology and Research (V. Cox) and the Department of Medicine (H. McIlleron), University of Cape Town, and the Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine (S.W.) - both in Cape Town, South Africa; the Institute of Tropical Medicine, Antwerp, Belgium (B. C. J.); Médecins Sans Frontières, Geneva (G.F., N.L.); Médecins Sans Frontières, Yerevan, Armenia (O.K.); the National Center for Tuberculosis and Lung Diseases, Tbilisi, Georgia (N.K.); Partners In Health (M.K.) and Jhpiego Lesotho (L.O.) - both in Maseru; Socios En Salud Sucursal Peru (L.L., S.M.-T., J.R., E.S.-G., D.E.V.-V.), Hospital Nacional Sergio E. Bernales, Centro de Investigacion en Enfermedades Neumologicas (E.S.-G.), Hospital Nacional Dos de Mayo (E.T.), Universidad Nacional Mayor de San Marcos (E.T.), and Hospital Nacional Hipólito Unanue (D.E.V.-V.) - all in Lima; Global Health and Social Medicine, Harvard Medical School (L.L., K.J.S., M.L.R., C.D.M.), Partners In Health (L.L., K.J.S., M.L.R., C.D.M.), the Division of Global Health Equity, Brigham and Women's Hospital (K.J.S., M.L.R., C.D.M.), the Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, (L.T.), and Harvard T.H. Chan School of Public Health (L.T.) - all in Boston; and the Indus Hospital and Health Network, Karachi, Pakistan (H. Mushtaque, N.S.).
Background: For decades, poor treatment options and low-quality evidence plagued care for patients with rifampin-resistant tuberculosis. The advent of new drugs to treat tuberculosis and enhanced funding now permit randomized, controlled trials of shortened-duration, all-oral treatments for rifampin-resistant tuberculosis.
Methods: We conducted a phase 3, multinational, open-label, randomized, controlled noninferiority trial to compare standard therapy for treatment of fluoroquinolone-susceptible, rifampin-resistant tuberculosis with five 9-month oral regimens that included various combinations of bedaquiline (B), delamanid (D), linezolid (L), levofloxacin (Lfx) or moxifloxacin (M), clofazimine (C), and pyrazinamide (Z).
J Am Coll Health
January 2025
Department of Clinical and Applied Movement Sciences, Brooks College of Health, University of North Florida, Jacksonville, Florida, USA.
To identify student diversity, physical activity (PA), and PA referrals to PA counseling by campus healthcare providers (HCPs). University students ( = 1030, M = 21.14) utilizing on-campus healthcare.
View Article and Find Full Text PDFCien Saude Colet
January 2025
Escola de Enfermagem Aurora Afonso Costa, Universidade Federal Fluminense. R. Dr. Celestino 74, Centro. 24020-091 Niterói RJ Brasil.
The aim is to unveil the useful value of breastfeeding for lactating women in a prison environment, based on Max Scheler's axiological perspective. This work was a qualitative, developed in a prison unit in Rio de Janeiro, where seven lactating women were interviewed. The phenomenological interview was used for data collection, while Laurence Bardin's content analysis was used for data analysis and treatment.
View Article and Find Full Text PDFCien Saude Colet
January 2025
Instituto René Rachou, Fundação Oswaldo Cruz (Fiocruz Minas). Av. Augusto de Lima 1715, Barro Preto. 30190-002 Belo Horizonte MG Brasil.
This article aims to identify the relationship between material deprivation and mortality from breast, cervical, and prostate neoplasms in the Brazilian adult population and the relationship between ethnicity/skin color and material deprivation. This cross-sectional ecological study calculated the mean mortality rate per 100,000 inhabitants, and deaths were standardized by age and gender and redistributed per to ill-defined causes, stratified by age group and ethnicity/skin color. We applied the Negative Binomial model, containing the interaction between ethnicity/skin color and the Brazilian Deprivation Index (IBP).
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