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Journal articles on the topic 'HIV infections - Zambia - Prevention'

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Published: 4 June 2021
Last updated: 1 February 2022

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1

Stelzle, Dominik, Peter Godfrey-Faussett, Chuan Jia, et al. "Estimating HIV pre-exposure prophylaxis need and impact in Malawi, Mozambique and Zambia: A geospatial and risk-based analysis." PLOS Medicine 18, no. 1 (2021): e1003482. http://dx.doi.org/10.1371/journal.pmed.1003482.

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Background Pre-exposure prophylaxis (PrEP), a WHO-recommended HIV prevention method for people at high risk for acquiring HIV, is being increasingly implemented in many countries. Setting programmatic targets, particularly in generalised epidemics, could incorporate estimates of the size of the population likely to be eligible for PrEP using incidence-based thresholds. We estimated the proportion of men and women who would be eligible for PrEP and the number of HIV infections that could be averted in Malawi, Mozambique, and Zambia using prioritisation based on age, sex, geography, and markers of risk. Methods and findings We analysed the latest nationally representative Demographic and Health Surveys (DHS) of Malawi, Mozambique, and Zambia to determine the proportion of adults who report behavioural markers of risk for HIV infection. We used prevalence ratios (PRs) to quantify the association of these factors with HIV status. Using a multiplier method, we combined these proportions with the number of new HIV infections by district, derived from district-level modelled HIV estimates. Based on these numbers, different scenarios were analysed for the minimum number of person-years on PrEP needed to prevent 1 HIV infection (NNP). An estimated total of 38,000, 108,000, and 46,000 new infections occurred in Malawi, Mozambique, and Zambia in 2016, corresponding with incidence rates of 0.43, 0.63, and 0.57 per 100 person-years. In these countries, 9%–20% of new infections occurred among people with a sexually transmitted infection (STI) in the past 12 months and 40%–42% among people with either an STI or a non-regular sexual partner (NP) in the past 12 months (STINP). The models estimate that around 50% of new infections occurred in districts with incidence rates ≥1.0% in Mozambique and Zambia and ≥0.5% in Malawi. In Malawi, Mozambique, and Zambia, 35.1%, 21.9%, and 12.5% of the population live in these high-incidence districts. In the most parsimonious scenario, if women aged 15–34 years and men 20–34 years with an STI in the past 12 months living in high-incidence districts were to take PrEP, it would take a minimum of 65.8 person-years on PrEP to avert 1 HIV infection per year in Malawi, 35.2 in Mozambique, and 16.4 in Zambia. Our findings suggest that 3,300, 5,200, and 1,700 new infections could be averted per year in the 3 countries, respectively. Limitations of our study are that these values are based on modelled estimates of HIV incidence and self-reported behavioural risk factors from national surveys. Conclusions A large proportion of new HIV infections in these 3 African countries were estimated to occur among people who had either an STI or an NP in the past year, providing a straightforward means to set PrEP targets. Greater prioritisation of PrEP by district, sex, age, and behavioural risk factors resulted in lower NNPs thereby increasing PrEP cost-effectiveness, but also diminished the overall impact on reducing new infections
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Hachaambwa, Lottie, Cassidy Claassen, Lloyd Mulenga, et al. "1321. The UNZA/UMB MMed ID Collaboration: Training and Retaining HIV Specialist Physicians in Zambia." Open Forum Infectious Diseases 5, suppl_1 (2018): S403—S404. http://dx.doi.org/10.1093/ofid/ofy210.1154.

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Abstract Background To mitigate the HIV pandemic and increasing outbreaks of infectious diseases, sub-Saharan African countries need increased healthcare worker capacity at all levels. We describe a successful collaboration between the Ministry of Health (MOH), the University Teaching Hospital (UTH), the University of Zambia (UNZA), and the University of Maryland Baltimore (UMB) to train Zambian physicians in advanced HIV medicine and infectious diseases. Methods Recognizing the need for advanced HIV clinical care expertise in Zambia, UNZA, UTH and UMB partnered in 2008 to create a 1-year Postgraduate Diploma in HIV Medicine. The consortium extended this to an 18-month Master of Science in HIV Medicine to better align with existing professional advancement schema. In 2012, UNZA and UMB started a 4-year Master of Medicine in infectious diseases (MMedID), which was then expanded to a 5-year training program combining internal medicine and infectious disease (MMed IM/ID) in order to produce a cadre with wider expertise in internal medicine and infectious diseases. Instruction consists of bedside teaching, didactic lectures, case conferences, and journal clubs. The bulk of teaching came from UMB clinical faculty with expertise in HIV and ID; faculty are either based in Zambia or visit from the United States. Results The MSc HIV program trained 27 physicians; of these, 24 (89%) are in health leadership positions in Zambia, with 17 (63%) directly involved in clinical care (mostly in the public sector), while 7 (15%) work for international implementing partners in Zambia. 1 physician emigrated to another African country, another one died and the third is in clinical nonleadership position in Zambia. The MMed ID program has enrolled 14 physicians. The first two graduates of the program completed the program in 2017 and took health leadership roles within the MOH as well as teaching positions at UNZA. Conclusion Educational collaborations embedded within local institutions and structures can provide advanced healthcare expertise within resource-limited settings. The UNZA/UMB MMed IM/ID collaboration is a model example of a successful university partnership that has resulted in retaining health leadership and clinical care expertise in Zambia. Disclosures L. Hachaambwa, Centers for Disease Control and Prevention (CDC): Cooperative Agreement to Institution, Financial support for the work described in this abstract was made possible by a cooperative agreement award from the Centers for Disease Control and Prevention (CDC) to the University of Zambia and to the University of Maryland School of Medicine.
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Lukobo, M. D., and R. C. Bailey. "Acceptability of male circumcision for prevention of HIV infection in Zambia." AIDS Care 19, no. 4 (2007): 471–77. http://dx.doi.org/10.1080/09540120601163250.

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4

MALHOTRA, NISHA, and JONATHAN YANG. "RISKY BEHAVIOUR AND HIV PREVALENCE AMONG ZAMBIAN MEN." Journal of Biosocial Science 43, no. 2 (2011): 155–65. http://dx.doi.org/10.1017/s0021932010000647.

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SummaryThe objective of this paper is to identify demographic, social and behavioural risk factors for HIV infection among men in Zambia. In particular, the role of alcohol, condom use and number of sex partners is highlighted as being significant in the prevalence of HIV. Multivariate logistic regressions were used to analyse the latest cross-sectional population-based demographic health survey for Zambia (2007). The survey included socioeconomic variables and HIV serostatus for consenting men (N=4434). Risk for HIV was positively related to wealth status. Men who considered themselves to be at high risk of being HIV positive were most likely to be HIV positive. Respondents who, along with their sexual partner, were drunk during the last three times they had sexual intercourse were more likely to be HIV positive (adjusted odds ratio (AOR) 1.60; 95% confidence interval (CI) 1.00–2.56). Men with more than two sexual life partners and inconsistent condom use had a higher risk for being HIV positive (OR 1.89, 95% CI 1.45–2.46; and OR 1.49, 95% CI 1.10–2.02, respectively). HIV prevention programmes in Zambia should focus even more on these behavioural risk factors.
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Sanjobo, Nawa, Matilda Lukwesa, Charity Kaziya, Cornwell Tepa, and Bernard Puta. "Evolution of HIV and AIDS Programmes in an African Institution of Higher Learning: The Case of the Copperbelt University in Zambia." Open AIDS Journal 10, no. 1 (2016): 24–33. http://dx.doi.org/10.2174/1874613601610010024.

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Background: Universities present the foundation for socio-economic and political development. Without structures and processes to fight HIV, there is no prospect of enhancing treatment, prevention, care and support services. Copperbelt University HIV and AIDS response was initiated in 2003 with the aim of building capacity of students and employees in HIV and AIDS. Objectives: The main objective of this paper is to demonstrate how the CBU HIV response has evolved over time and provide a timeline of important milestones in the development process. Method: Peer educators and counsellors conduct sensitization campaigns through one on one discussion, workshops, and drama performances, distribution of Information, Education and Communication (IEC) materials. Results: HIV Programme has been set up with players from policy, programme and community levels. Strategic processes, collaborations, funding, medical insurance schemes, prevention, treatment, care and support services, training of peer educators and counsellors have been established. Conclusion: Copperbelt University HIV initiative has demonstrated potential to reduce new infections in the university, and is currently expanding her programme to encompass wellness and also spearhead the integration of HIV in the university curriculum.
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Alcaide, Maria L., Maureen Chisembele, Miriam Mumbi, Emeria Malupande, and Deborah Jones. "Examining Targets for HIV Prevention: Intravaginal Practices in Urban Lusaka, Zambia." AIDS Patient Care and STDs 28, no. 3 (2014): 121–27. http://dx.doi.org/10.1089/apc.2013.0309.

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7

KELLY, PAUL. "Treatment and prevention of cryptosporidiosis: what options are there for a country like Zambia?" Parasitology 138, no. 12 (2011): 1488–91. http://dx.doi.org/10.1017/s0031182011000035.

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SUMMARYCryptosporidiosis is a major infection of humans, leading to diarrhoea and growth failure in children, diarrhoea and malnutrition in immunocompromised adults, and is associated with increased mortality in all age groups. Using the country of Zambia as an example, I review the possible approaches to treatment and prevention in a tropical setting. The current optimal therapy for cryptosporidiosis is nitazoxanide which works well in HIV uninfected children, but treatment in patients with HIV infection remains remarkably difficult. No single drug has demonstrated efficacy in a randomised trial. No vaccine is available, so the best option for prevention for the moment is filtration and clean storage of drinking water. This would be expected to reduce cryptosporidiosis dramatically, but this needs to be demonstrated directly. Water filtration would have the added benefit of protection against many other pathogens, but the paucity of alternative approaches highlights the need for a better understanding of this important human pathogen.
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8

Hofmeyr, G. Justus, Charles S. Morrison, Jared M. Baeten, et al. "Rationale and design of a multi-center, open-label, randomised clinical trial comparing HIV incidence and contraceptive benefits in women using three commonly-used contraceptive methods (the ECHO study)." Gates Open Research 1 (December 29, 2017): 17. http://dx.doi.org/10.12688/gatesopenres.12775.1.

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Background: In vitro, animal, biological and observational clinical studies suggest that some hormonal methods, particularly depot medroxyprogesterone acetate – DMPA, may increase women’s risk of HIV acquisition. DMPA is the most common contraceptive used in many countries worst affected by the HIV epidemic. To provide robust evidence for contraceptive decision-making among women, clinicians and planners, we are conducting the Evidence for Contraceptive Options and HIV Outcomes (ECHO) study in four countries with high HIV incidence and DMPA use: Kenya, South Africa, Swaziland, and Zambia (Clinical Trials.gov identifier NCT02550067). Study design: We randomized HIV negative, sexually active women 16-35 years old requesting effective contraception and agreeing to participate to either DMPA, the copper T 380A intrauterine device or levonorgestrel implant. Participants attend a contraception support visit after 1 month and quarterly visits thereafter for 12 to 18 months. Participants receive a standard HIV prevention package and contraceptive side-effect management at each visit. The primary outcome is HIV seroconversion. Secondary outcomes include pregnancy, serious adverse events and method discontinuation. The sample size of 7800 women provides 80% power to detect a 50% difference in HIV risk between any of the three method pairs, assuming 250 incident infections per comparison. Ethical considerations: Several WHO consultations have concluded that current evidence on HIV risk associated with DMPA is inconclusive and that a randomized trial is needed to guide policy, counselling and choice. Previous studies suggest that women without a specific contraceptive preference are willing to accept randomization to different contraceptive methods. Stringent performance standards are monitored by an independent data and safety monitoring board approximately every 6 months. The study has been conducted with extensive stakeholder engagement. Conclusions: The ECHO study is designed to provide robust evidence on the relative risks (HIV acquisition) and benefits (pregnancy prevention) between three effective contraceptive methods.
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Hofmeyr, G. Justus, Charles S. Morrison, Jared M. Baeten, et al. "Rationale and design of a multi-center, open-label, randomised clinical trial comparing HIV incidence and contraceptive benefits in women using three commonly-used contraceptive methods (the ECHO study)." Gates Open Research 1 (March 13, 2018): 17. http://dx.doi.org/10.12688/gatesopenres.12775.2.

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Background: In vitro, animal, biological and observational clinical studies suggest that some hormonal methods, particularly depot medroxyprogesterone acetate – DMPA, may increase women’s risk of HIV acquisition. DMPA is the most common contraceptive used in many countries worst affected by the HIV epidemic. To provide robust evidence for contraceptive decision-making among women, clinicians and planners, we are conducting the Evidence for Contraceptive Options and HIV Outcomes (ECHO) study in four countries with high HIV incidence and DMPA use: Kenya, South Africa, Swaziland, and Zambia (Clinical Trials.gov identifier NCT02550067). Study design: We randomized HIV negative, sexually active women 16-35 years old requesting effective contraception and agreeing to participate to either DMPA, the copper T 380A intrauterine device or levonorgestrel implant. Participants attend a contraception support visit after 1 month and quarterly visits thereafter for up to 18 months. Participants receive a standard HIV prevention package and contraceptive side-effect management at each visit. The primary outcome is HIV seroconversion. Secondary outcomes include pregnancy, serious adverse events and method discontinuation. The sample size of 7800 women provides 80% power to detect a 50% relative increase in HIV risk between any of the three method pairs, assuming 250 incident infections per comparison. Ethical considerations: Several WHO consultations have concluded that current evidence on HIV risk associated with DMPA is inconclusive and that a randomized trial is needed to guide policy, counselling and choice. Previous studies suggest that women without a specific contraceptive preference are willing to accept randomization to different contraceptive methods. Stringent performance standards are monitored by an independent data and safety monitoring board approximately every 6 months. The study has been conducted with extensive stakeholder engagement. Conclusions: The ECHO study is designed to provide robust evidence on the relative risks (HIV acquisition) and benefits (pregnancy prevention) between three effective contraceptive methods.
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10

Hira, S. K., P. J. Feldblum, J. Kamanga, G. Mukelabai, S. S. Weir, and J. C. Weir. "Condom and Nonoxynol-9 use and the incidence of HIV infection in serodiscordant couples in Zambia." International Journal of STD & AIDS 8, no. 4 (1997): 243–50. http://dx.doi.org/10.1258/0956462971919994.

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We aimed to measure the effectiveness of latex condoms and of nonoxynol-9 [N-9] spermicides, in preventing HIV transmission in heterosexual serodiscordant couples in Lusaka. Each couple was examined at clinic visits scheduled at 3-month intervals for one year or more per couple, or until seroconversion or discontinuation. Couples were given condoms and their choice of 3 N-9 products and advised to use both at every intercourse. Sexual exposure was ascertained from coital logs that recorded coitus and barrier method use. HIV serological testing was done at each clinic visit (ELISA and Western blot if positive). One hundred and ten discordant couples were followed for a mean of 17.6 months. Seventy-eight per cent of coital episodes were protected by condoms, 85% by spermicides and 6.4% were unprotected. Fourteen seroconversions occurred (8.7 infections per 100 couple-years [c-y]). The rate was higher among seronegative men than seronegative women. Among couples who reported using condoms at every intercourse the infection rate was 2.3/100 c-y, compared with 10.7/100 c-y among couples using condoms less consistently (rate ratio [RR] 0.2; 95% confidence interval [CI] 0-1.6). Among couples who reported using N-9 at every intercourse, the seroconversion rate was 6.9/100 c-y; among couples who reported less than fulltime N-9 use, the rate was 8.9/100 c-y (RR 0.8; 95% CI 0.2-2.8). Among the subset of female seronegatives, the N-9 RR was 0.5 (95% CI 0.1-3.8). But when we calculated HIV rates according to N-9 consistency in coital acts when condoms were not used, there was no evidence of protection with higher N-9 use. Consistent use of latex condoms reduces the incidence of HIV infection, but the association between N-9 spermicides and HIV is less clear. The current study could not provide compelling data on the impact of N-9 spermicide use on risk of HIV infection. The study's small size, as well as the consistency of concurrent condom use, limited our inferences. Available spermicide products must be studied further.
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Dionne-Odom, Jodie, Thomas K. Welty, Andrew O. Westfall, et al. "Factors Associated with PMTCT Cascade Completion in Four African Countries." AIDS Research and Treatment 2016 (2016): 1–9. http://dx.doi.org/10.1155/2016/2403936.

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Background. Many countries are working to reduce or eliminate mother-to-child transmission (MTCT) of HIV. Prevention efforts have been conceptualized as steps in a cascade but cascade completion rates during and after pregnancy are low. Methods. A cross-sectional survey was performed across 26 communities in Cameroon, Cote d’Ivoire, South Africa, and Zambia. Women who reported a pregnancy within two years were enrolled. Participant responses were used to construct the PMTCT cascade with all of the following steps required for completion: at least one antenatal visit, HIV testing performed, HIV testing result received, initiation of maternal prophylaxis, and initiation of infant prophylaxis. Factors associated with cascade completion were identified using multivariable logistic regression modeling. Results. Of 976 HIV-infected women, only 355 (36.4%) completed the PMTCT cascade. Although most women (69.2%) did not know their partner’s HIV status; awareness of partner HIV status was associated with cascade completion (aOR 1.4, 95% CI 1.01–2.0). Completion was also associated with receiving an HIV diagnosis prior to pregnancy compared with HIV diagnosis during or after pregnancy (aOR 14.1, 95% CI 5.2–38.6). Conclusions. Pregnant women with HIV infection in Africa who were aware of their partner’s HIV status and who were diagnosed with HIV before pregnancy were more likely to complete the PMTCT cascade.
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Moramarco, Stefania, Giulia Amerio, Jean Kasengele Chipoma, Karin Nielsen-Saines, Leonardo Palombi, and Ersilia Buonomo. "Filling the Gaps for Enhancing the Effectiveness of Community-Based Programs Combining Treatment and Prevention of Child Malnutrition: Results from the Rainbow Project 2015–17 in Zambia." International Journal of Environmental Research and Public Health 15, no. 9 (2018): 1807. http://dx.doi.org/10.3390/ijerph15091807.

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Background: Child malnutrition, in all its forms, is a public health priority in Zambia. After implementations based on a previous evaluation in 2012–14 were made, the efficacy of the Rainbow Project Supplementary Feeding Programs (SFPs) for the integrated management of severe acute malnutrition (SAM), moderate acute malnutrition (MAM), and underweight was reassessed in 2015–17. Methods: The outcomes were compared with International Standards and with those of 2012–14. Cox proportional risk regression analysis was performed to identify predictors of mortality and defaulting. Results: The data for 900 under-five year-old malnourished children were analyzed. Rainbow’s 2015–17 outcomes met International Standards, for total and also when stratified for different type of malnutrition. A better performance than 2012–14 was noted in the main areas previously identified as critical: mortality rates were halved (5.6% vs. 3.1%, p = 0.01); significant improvements in average weight gain and mean length of stay were registered for recovered children (p < 0.001). HIV infection (5.5; 1.9–15.9), WAZ <–3 (4.6; 1.3–16.1), and kwashiorkor (3.5; 1.2–9.5) remained the major predictors of mortality. Secondly, training community volunteers consistently increased the awareness of a child’s HIV status (+30%; p < 0.001). Conclusion: Rainbow SFPs provide an integrated community-based approach for the treatment and prevention of child malnutrition in Zambia, with its effectiveness significantly enhanced after the gaps in activities were filled.
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Malama, Kalonde, Luis Sagaon-Teyssier, Rachel Parker, et al. "Factors associated with alcohol use before sex among HIV-negative female sex workers in Zambia." International Journal of STD & AIDS 31, no. 2 (2020): 119–26. http://dx.doi.org/10.1177/0956462419886159.

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Female sex workers (FSWs) are at high risk of HIV infection. Alcohol use prior to sex can compound this risk. We investigated the factors associated with having sex under the influence of alcohol among Zambian FSWs. Community health workers and peer FSWs recruited 331 HIV-negative FSWs in Lusaka and Ndola. In a cross-sectional survey, we asked FSWs how often they had sex under the influence of alcohol in the previous month and categorised responses as ‘always’ and ‘not always’. The adjusted odds ratios (AORs) of always having sex under the influence of alcohol were higher among FSWs who charged clients medium (AOR: 2.20, 95% confidence interval [CI]: 1.04–4.68) and low fees (AOR: 2.65, 95% CI: 1.26–5.60) for sex versus high fees; received 9–19 (AOR: 2.37, 95% CI: 1.15–4.91) and 20 or more clients per month (AOR: 3.06, 95% CI: 1.47–6.37) versus up to 8 clients per month; and never used condoms versus always used condoms with clients (AOR: 4.21, 95% CI: 1.53–11.55). FSWs who always used alcohol before sex appeared more likely to engage in riskier sex and charge clients lower fees. Interventions for financial empowerment and alcohol risk reduction should complement existing HIV prevention interventions for FSWs.
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Nichols, Brooke E., Charles A. B. Boucher, Janneke H. van Dijk, et al. "Cost-Effectiveness of Pre-Exposure Prophylaxis (PrEP) in Preventing HIV-1 Infections in Rural Zambia: A Modeling Study." PLoS ONE 8, no. 3 (2013): e59549. http://dx.doi.org/10.1371/journal.pone.0059549.

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15

Tate, Jackie, Kavita Singh, Phillimon Ndubani, Jolly Kamwanga, and Bates Buckner. "Measurement of HIV Prevention Indicators: A Comparison of the PLACE Method and a Household Survey in Zambia." AIDS and Behavior 14, no. 1 (2008): 209–17. http://dx.doi.org/10.1007/s10461-008-9505-y.

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16

Hanke, Tomáš, Patricia Fast, Pontiano Kaleebu, et al. "OC 8499 THE T-CELL VACCINE STRATEGY: GLOBALLY RELEVANT AIDS VACCINE EUROPE-AFRICA TRIALS PARTNERSHIP (GREAT)." BMJ Global Health 4, Suppl 3 (2019): A10.3—A11. http://dx.doi.org/10.1136/bmjgh-2019-edc.25.

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BackgroundRemarkable progress has been achieved in decreasing AIDS-related deaths and HIV-1 transmission through ART. Nevertheless, an affordable, effective and durable HIV-1 vaccine protection remains the best solution for halting the AIDS epidemic.Our aim is to develop a vaccine inducing cytotoxic T lymphocytes (CTL), which effectively inhibit HIV-1 replication and complement bnAbs for prevention; such T cells are likely critical for a successful cure. Central to our strategy is to focus HIV-1-specific CTL on the most functionally conserved regions (not a string of epitopes and not full-length proteins) common to most HIV-1 variants, which HIV-1 typically cannot change without losing fitness. These conserved regions were defined by bioinformatics, and a bivalent mosaic was computationally designed to increase the vaccine perfect match of potential T-cell epitopes to 80% of global HIV-1 variants; if successful, the vaccine will be suitable for global deployment. Furthermore, we maximised the inclusion of protective epitopes associated with viral control in treatment-naive HIV-1-positive individuals defined on 4 continents. These immunogens are delivered by the non-replicating simian adenovirus ChAdOx1 prime and non-replicating poxvirus MVA boost regimen, clinically proven safe and potent.MethodsThe GREAT consortium has been established to build capacity for a future efficacy trial in Zambia, around Lake Victoria and in Kenya by engaging populations at documented high risk for HIV-1 infection, despite preventive interventions, by diverse clades. We will conduct a phase I/IIa clinical trial HIV-CORE 006 to assess the safety and immunogenicity of the conserved-region vaccines, in preparation for an efficacy trial in these at-risk populations.ConclusionThe aims of the GREAT consortium are to ensure that at the completion of the programme grant, the vaccine regimen will be proven safe and potent, and the sites will be prepared to launch an appropriately designed trial to prove vaccine efficacy.
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Molassiotis, Alexander, Irene Saralis-Avis, Wilson Nyirenda, and Nina Atkins. "The Simalelo Peer Education Programme for HIV prevention: a qualitative process evaluation of a project in Zambia." African Journal of AIDS Research 3, no. 2 (2004): 183–90. http://dx.doi.org/10.2989/16085900409490333.

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Gartland, Matthew G., Namwinga T. Chintu, Michelle S. Li, et al. "Field effectiveness of combination antiretroviral prophylaxis for the prevention of mother-to-child HIV transmission in rural Zambia." AIDS 27, no. 8 (2013): 1253–62. http://dx.doi.org/10.1097/qad.0b013e32835e3937.

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Strasser, Susan, Edward Bitarakwate, Michelle Gill, et al. "Introduction of Rapid Syphilis Testing Within Prevention of Mother-to-Child Transmission of HIV Programs in Uganda and Zambia." JAIDS Journal of Acquired Immune Deficiency Syndromes 61, no. 3 (2012): e40-e46. http://dx.doi.org/10.1097/qai.0b013e318267bc94.

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Ntombela, Nonzwakazi P., Tivani P. Mashamba-Thompson, Andile N. Mtshali, Desmond Kuupiel, and Ayesha BM Kharsany. "HIV Risks in Sexual Networks of Heterosexual Men in South Africa." Global Journal of Health Science 11, no. 13 (2019): 146. http://dx.doi.org/10.5539/gjhs.v11n13p146.

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BACKGROUND: The interaction of HIV risks in sexual networks remains unclear in South Africa. We provide an overview of the dynamics of HIV risks in South African men through a systematic scoping review. METHODS &amp; ANALYSIS: Literature searches were conducted on seven online databases. Two reviewers independently screened articles against the inclusion criteria and performed a Kappa coefficient test to evaluate the degree of agreement on article selection. Thematic content analysis and a Mixed Method Appraisal Tool version 2018 were used to present the narrative account of the outcomes and to assess the risk of bias on included studies. RESULTS: Of the 1356 records identified, six studies reported on the dynamics of HIV infection in heterosexual men in sexual networks. All studies that were included were published between 2006 and 2016. The participants were aged 13 years and above and comprised of sero-discordant couples, HIV patients, and male and female in the general population. These studies were conducted in multiple diverse regions including South Africa, Senegal, Uganda, Malawi, Kenya, Tanzania, Botswana and Zambia. Evidence showed that age and sexual partnerships were most commonly identified attributes to either HIV infection and/or transmission risks in men. While other biological and behavioral data were reported, the results were not specific to men. DISCUSSION: The impact of age and sexual partnerships are poorly understood and the data available limit inferences to South African men. Limited empiric evidence of HIV risk among men impacts on the design, development and tailoring of HIV prevention interventions to alter the trajectory.
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Rodriguez, Violeta J., Maureen Chisembele, Deborah L. Jones, Ryan Cook, Stephen M. Weiss, and Maria L. Alcaide. "Influencing the importance of health, partners, and hygiene among Zambian women." International Journal of STD & AIDS 29, no. 3 (2017): 259–65. http://dx.doi.org/10.1177/0956462417723546.

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Intravaginal practices (IVPs) are common in Zambia and are usually practiced for hygiene, partner pleasure, and health. IVPs are associated with HIV acquisition, changes in the vaginal flora, and bacterial vaginosis (BV), making it important to understand the decision-making process behind IVP engagement. The Women’s and Sexual Health (WASH) intervention decreased IVP engagement among HIV-infected Zambian women, though change in reasons for engagement has not been assessed. We used conjoint analysis (CA) to quantify the decision-making process of IVP engagement and evaluated how the WASH intervention impacted these factors. Participants were N = 84 women (37 ± 8 years old) randomized to WASH (n = 46) or standard of care plus (SOC+; n = 38) who completed demographic measures and a CA questionnaire at baseline, six months, and 12 months to quantify the importance placed on hygiene, partner pleasure, and health. The importance placed on health increased from baseline to six months (15.5 versus 25.1; p < 0.001) and from baseline to 12 months (15.5 versus 50.5; p < 0.001), and was higher in SOC+ at six months (19.9 versus 30.3; p = 0.003). Hygiene importance decreased from baseline (63.6) to six months (50.3), and from baseline to 12 months (26.1), and was higher in the experimental arm at six months (56.1) compared to SOC+ (44.6; p = 0.029). Importance placed on partner pleasure did not change over time in either group. Findings suggest that both groups exhibited an increase in the importance placed on health and a decrease on hygiene importance for IVP engagement, suggesting that SOC+ may be sufficient to promote attitude changes that may facilitate IVP discontinuation and may prove to be more cost effective by using fewer monetary resources. Findings highlight the potential of interventions to influence attitudes toward IVPs and provide novel avenues for research to improve the design and conduct of interventions aimed at reducing IVPs among Zambian women and contribute to HIV prevention efforts.
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Bruce, Elizabeth. "Committing to comprehensive sexuality education for young people in Eastern and Southern Africa." education policy analysis archives 26 (October 22, 2018): 138. http://dx.doi.org/10.14507/epaa.26.3467.

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The Ministerial Commitment on Comprehensive Sexuality Education and Sexual and Reproductive Health Services for Adolescents and Young People in Eastern and Southern Africa (ESA), or the ESA Commitment, was affirmed December 7, 2013, by 21 countries located across this region during the 17th International Conference on AIDS and Sexually Transmitted Infections in Africa. The ESA Commitment speaks to the numerous practices and challenges of school age populations stemming from interplay among education, health, and contextual issues varying by country. Analysis of this policy is approached using methodology drawn from Bartlett and Vavrus (2014, 2017) and using a lens of policy borrowing, particularly focused on incorporating agency, process, impact, and timing (Steiner-Khamsi, 2000, 2010). This analysis seeks to understand the ESA Commitment and national curriculum subsequently implemented in Zambia by situating these actions among broader international, regional, and national discourse in the area of sexual and reproductive health and education for young people between 1994 and 2016. Through analysis considering its effectiveness in terms of implementation, scalability, and sustainability, its ability to enable progress towards improving the lives of young people, especially through increased knowledge of HIV/AIDS prevention, is examined and recommendations are presented.
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Simooya, Oscar O., Nawa Sanjobo, Chanda Mulenga, et al. "Aggressive Awareness Campaigns May Not be Enough for HIV Prevention in Prisons-Studies in Zambia Suggest Time for Evidence Based Interventions." Open Infectious Diseases Journal 8, no. 1 (2014): 1–7. http://dx.doi.org/10.2174/1874279301408010001.

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Awopegba, Oluwafemi Emmanuel, Amarachi Kalu, Bright Opoku Ahinkorah, Abdul-Aziz Seidu, and Anthony Idowu Ajayi. "Prenatal care coverage and correlates of HIV testing in sub-Saharan Africa: Insight from demographic and health surveys of 16 countries." PLOS ONE 15, no. 11 (2020): e0242001. http://dx.doi.org/10.1371/journal.pone.0242001.

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Background Prenatal screening of pregnant women for HIV is central to eliminating mother-to-child-transmission (MTCT) of HIV. While some countries in sub-Saharan Africa (SSA) have scaled up their prevention of MTCT programmes, ensuring a near-universal prenatal care HIV testing, and recording a significant reduction in new infection among children, several others have poor outcomes due to inadequate testing. We conducted a multi-country analysis of demographic and health surveys (DHS) to assess the coverage of HIV testing during pregnancy and also examine the factors associated with uptake. Methods We analysed data of 64,933 women from 16 SSA countries with recent DHS datasets (2015–2018) using Stata version 16. Adjusted and unadjusted logistic regression models were used to examine correlates of prenatal care uptake of HIV testing. Statistical significance was set at p<0.05. Results Progress in scaling up of prenatal care HIV testing was uneven across SSA, with only 6.1% of pregnant women tested in Chad compared to 98.1% in Rwanda. While inequality in access to HIV testing among pregnant women is pervasive in most SSA countries and particularly in West and Central Africa sub-regions, a few countries, including Rwanda, South Africa, Zimbabwe, Malawi and Zambia have managed to eliminate wealth and rural-urban inequalities in access to prenatal care HIV testing. Conclusion Our findings highlight the between countries and sub-regional disparities in prenatal care uptake of HIV testing in SSA. Even though no country has universal coverage of prenatal care HIV testing, East and Southern African regions have made remarkable progress towards ensuring no pregnant woman is left untested. However, the West and Central Africa regions had low coverage of prenatal care testing, with the rich and well educated having better access to testing, while the poor rarely tested. Addressing the inequitable access and coverage of HIV testing among pregnant women is vital in these sub-regions.
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Stringer, Elizabeth M., Moses Sinkala, Jeffrey S. A. Stringer, et al. "Prevention of mother-to-child transmission of HIV in Africa: successes and challenges in scaling-up a nevirapine-based program in Lusaka, Zambia." AIDS 17, no. 9 (2003): 1377–82. http://dx.doi.org/10.1097/00002030-200306130-00012.

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Evans, William, Kuyosh Kadirov, Ibou Thior, Ramakrishnan Ganesan, Alec Ulasevich, and Bidia Deperthes. "Willingness to Pay for Condoms among Men in Sub-Saharan Africa." International Journal of Environmental Research and Public Health 16, no. 1 (2018): 34. http://dx.doi.org/10.3390/ijerph16010034.

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HIV/AIDS and other sexually transmitted infections (STIs) continue to be among the greatest public health threats worldwide, especially in sub-Saharan Africa (SSA). Condom use remains an essential intervention to eradicate AIDS, and condom use is now higher than ever. However, free and subsidized condom funding is declining. Research on how to create healthy markets based on willingness to pay for condoms is critically important. This research has three primary aims: (1) willingness of free condom users in five African countries to pay for socially marketed condoms; (2) the relationship between specific population variables and condom brand marketing efforts and willingness to pay; and (3) potential opportunities to improve condom uptake. Nationally representative samples of at least 1200 respondents were collected in Kenya, Nigeria, South Africa, Zambia, and Zimbabwe. We collected data on a range of demographic factors, including condom use, sexual behavior, awareness of condom brands, and willingness to pay. We estimated multivariate linear regression models and found that free condom users are overwhelmingly willing to pay for condoms overall (over 90% in Nigeria) with variability by country. Free users were consistently less willing to pay for condoms if they had a positive identification with their free brand in Kenya and Zimbabwe, suggesting that condom branding is a critical strategy. Ability to pay was negatively correlated with willingness, but users who could not obtain free condoms were willing to pay for them in Kenya and Zimbabwe. In a landscape of declining donor funding, this research suggests opportunities to use scarce funds for important efforts such as campaigns to increase demand, branding of condoms, and coordination with commercial condom manufacturers to build a healthy total market approach for the product. Free condoms remain an important HIV/AIDS prevention tool. Building a robust market for paid condoms in SSA is a public health priority.
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Vermund, Sten H., Sarah J. Fidler, Helen Ayles, Nulda Beyers, and Richard J. Hayes. "Can Combination Prevention Strategies Reduce HIV Transmission in Generalized Epidemic Settings in Africa? The HPTN 071 (PopART) Study Plan in South Africa and Zambia." JAIDS Journal of Acquired Immune Deficiency Syndromes 63 (July 2013): S221—S227. http://dx.doi.org/10.1097/qai.0b013e318299c3f4.

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Hargreaves, JR, A. Stangl, V. Bond, et al. "P14.13 Hiv-related stigma and universal testing and treatment for hiv prevention and care: design of an implementation science evaluation nested in the hptn 071 (popart) cluster-randomised trial in zambia and south africa." Sexually Transmitted Infections 91, Suppl 2 (2015): A202.3—A203. http://dx.doi.org/10.1136/sextrans-2015-052270.525.

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Cabanes, Anna, Mary Rose Giattas, Mavalynne Orozco-Urdaneta, et al. "Different Routes, Similar Destination: Building Breast Care Models in Tanzania, Zambia, and Colombia." Journal of Global Oncology 4, Supplement 3 (2018): 7s. http://dx.doi.org/10.1200/jgo.18.10050.

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Purpose Cancer is becoming an urgent problem in low- and middle-income countries as the global burden of disease shifts from infectious to noncommunicable diseases. Whereas cervical cancer and breast cancer are preventable and treatable, these diseases are the leading causes of women’s cancer deaths in low-resource settings, mostly because of late-stage presentation and limited diagnostic and treatment capacities. Methods Using the Breast Health Global Initiative resource-stratified guidelines and a phased implementation approach, countries with resource constraints have designed and implemented breast cancer interventions that allow for a balanced, efficient, and equitable use of limited resources. Results Tanzania, Zambia, and a rural area of Colombia serve as examples of evidence-based approaches to the implementation of breast cancer control programs, leveraging the successes and experiences of existing care platforms—mostly cervical cancer and HIV—while creating a solid foundation for country ownership and sustainability. Tanzania used a top-down approach, investing in understanding the needs through a breast health care assessment to inform policy and practice, as well as building a national policy framework. Zambia analyzed the successes and experiences of their public Cervical Cancer Prevention Program to introduce breast cancer education, detection, and surgical treatment, and to improve the time of diagnosis for breast cancer using the single-visit approach recommended by WHO for cervical cancer. A rural community in Colombia has focused on mitigating some of the most common barriers that women face during their cancer journey by improving the cancer education of medical personnel, providing technology for early diagnosis, and implementing an outreach and navigation program that has significantly reduced waiting times from screening through diagnosis and treatment. Conclusion What are key characteristics that guarantee success? Country ownership is crucial, with political, institutional, and community ownership; capabilities; and accountability. Under these four dimensions and a phased implementation framework, we explain the approach that civil society, ministries of health, and stakeholders have taken to implement these programs. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Anna Cabanes Research Funding: Pfizer, Genentech, Merk (Inst) Travel, Accommodations, Expenses: Pfizer, Astra Zeneca Mary Rose Giattas Research Funding: Pfizer, Genentech, Merk (Inst) Travel, Accommodations, Expenses: Pfizer, Astra Zeneca Mavalynne Orozco Urdaneta Stock or Other Ownership: Celgene, Johnson and Johnson Armando Sardi Stock or Other Ownership: Celgene, Johnson and Johnson
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Chesney, M. A. "Prevention of HIV and STD Infections." Preventive Medicine 23, no. 5 (1994): 655–60. http://dx.doi.org/10.1006/pmed.1994.1109.

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Chirwa, B. U., and E. Sivile. "Enlisting the Support of Traditional Healers in An AIDS Education Campaign in Zambia." International Quarterly of Community Health Education 9, no. 3 (1988): 221–29. http://dx.doi.org/10.2190/deqp-8a5w-alu0-4xv4.

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A nationwide AIDS education campaign in Zambia was constrained by lack of support from traditional healers. First, some of them did not appreciate the nature of the new disease, and second, others hampered the education efforts by publicly claiming that they possessed curative and/or preventive medicines for HIV infection. To overcome communication barriers, the health education unit convened a workshop for traditional medical practitioners and their orthodox counterparts. An important feature of the workshop was interactive participatory small group discussion. At the close of the workshop significantly more healers understood the nature of AIDS and were willing to participate in the national information and education effort against AIDS.
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Wall, Kristin M., William Kilembe, Mubiana Inambao, et al. "Cost-effectiveness of integrated HIV prevention and family planning services for Zambian couples." AIDS 34, no. 11 (2020): 1633–42. http://dx.doi.org/10.1097/qad.0000000000002584.

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Vamos, Szonja, Miriam Mumbi, Ryan Cook, Ndashi Chitalu, Stephen Marshall Weiss, and Deborah Lynne Jones. "Translation and sustainability of an HIV prevention intervention in Lusaka, Zambia." Translational Behavioral Medicine 4, no. 2 (2013): 141–48. http://dx.doi.org/10.1007/s13142-013-0237-9.

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Alcaide, MariaL, Ndashi Chitalu, DeborahL Jones, and Stephen Weiss. "Chlamydia and gonorrhea infections in HIV-positive women in urban Lusaka, Zambia." Journal of Global Infectious Diseases 4, no. 3 (2012): 141. http://dx.doi.org/10.4103/0974-777x.100566.

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BANKOLE, AKINRINOLA, ANN E. BIDDLECOM, KUMBUTSO DZEKEDZEKE, JOSHUA O. AKINYEMI, OLUTOSIN AWOLUDE, and ISAAC F. ADEWOLE. "DOES KNOWLEDGE ABOUT ANTIRETROVIRAL THERAPY AND MOTHER-TO-CHILD TRANSMISSION AFFECT THE RELATIONSHIPS BETWEEN HIV STATUS AND FERTILITY PREFERENCES AND CONTRACEPTIVE USE? NEW EVIDENCE FROM NIGERIA AND ZAMBIA." Journal of Biosocial Science 46, no. 5 (2013): 580–99. http://dx.doi.org/10.1017/s0021932013000655.

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SummaryThe increasing availability of antiretroviral therapy (ART) and drug regimens to prevent mother-to-child transmission (PMTCT) has probably changed the context of childbearing for people living with HIV. Using data from 2009–2010 community-based surveys in Nigeria and Zambia, this study explores whether women's knowledge about ART and PMTCT influences the relationship between HIV status and fertility preferences and contraceptive behaviour. The findings show that women living with HIV are more likely to want more children in Nigeria and to want to limit childbearing in Zambia compared with HIV-negative women. While there is no significant difference in contraceptive use by women's HIV status in the two countries, women who did not know their HIV status are less likely to use contraceptives relative to women who are HIV-negative. Knowledge about ART reduces the childbearing desires of HIV-positive women in Nigeria and knowledge about PMTCT increases desire for more children among HIV-positive women in Zambia, as well as contraceptive use among women who do not know their HIV status. The findings indicate that knowledge about HIV prevention and treatment services changes how living with HIV affects childbearing desires and, at least in Zambia, pregnancy prevention, and highlight the importance of access to accurate knowledge about ART and PMTCT services to assist women and men to make informed childbearing decisions. Knowledge about ART and PMTCT should be promoted not only through HIV treatment and maternal and newborn care facilities but also through family planning centres and the mass media.
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Wilson, Mary E. "Infections in HIV-infected Travelers: Risks and Prevention." Annals of Internal Medicine 114, no. 7 (1991): 582. http://dx.doi.org/10.7326/0003-4819-114-7-582.

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O'Farrell, Nigel. "Control of sexually transmitted infections for HIV prevention." Lancet 372, no. 9646 (2008): 1297. http://dx.doi.org/10.1016/s0140-6736(08)61540-8.

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White, Richard, Connie Celum, Judith Wasserheit, Sevgi Aral, and Richard Hayes. "Control of sexually transmitted infections for HIV prevention." Lancet 372, no. 9646 (2008): 1297. http://dx.doi.org/10.1016/s0140-6736(08)61541-x.

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39

Carm, Ellen. "Exploring a Third Space for Sustainable Educational Development—HIV/AIDS Prevention, Zambia." Sustainability 10, no. 4 (2018): 946. http://dx.doi.org/10.3390/su10040946.

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Bond, Virginia, Elaine Chase, and Peter Aggleton. "Stigma, HIV/AIDS and prevention of mother-to-child transmission in Zambia." Evaluation and Program Planning 25, no. 4 (2002): 347–56. http://dx.doi.org/10.1016/s0149-7189(02)00046-0.

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41

Gisselquist, D. "Denialism undermines AIDS prevention in sub-Saharan Africa." International Journal of STD & AIDS 19, no. 10 (2008): 649–55. http://dx.doi.org/10.1258/ijsa.2008.008180.

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Some denialists, widely reviled, contend that HIV does not cause AIDS. Other denialists, widely respected, contend that HIV transmits so poorly through trace blood exposures that iatrogenic infections are rare. This second group of denialists has had a corrosive effect on public health and HIV programmes in sub-Saharan Africa. Guided by this second group of denialists, no African government has investigated unexplained HIV infections. Denialists have withheld and ignored research findings showing that non-sexual risks account for substantial proportions of HIV infections in Africa. Denialists have promoted invasive procedures for HIV prevention in Africa – injections for sexually transmitted infections, and adult male circumcision – without addressing unreliable sterilization of reused instruments. By denying that health care causes more than rare infections, denialists blame (stigmatize) HIV-positive African adults for causing their own infections through sexual behaviour. Denialism must be overcome to ensure safe health care and to combat HIV-related stigma in Africa.
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Aboud, S., G. Msamanga, J. S. Read, et al. "Genital tract infections among HIV-infected pregnant women in Malawi, Tanzania and Zambia." International Journal of STD & AIDS 19, no. 12 (2008): 824–32. http://dx.doi.org/10.1258/ijsa.2008.008067.

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43

Busch, Michael P., Evan M. Bloch, and Steven Kleinman. "Prevention of transfusion-transmitted infections." Blood 133, no. 17 (2019): 1854–64. http://dx.doi.org/10.1182/blood-2018-11-833996.

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Abstract Since the 1970s, introduction of serological assays targeting virus-specific antibodies and antigens has been effective in identifying blood donations infected with the classic transfusion-transmitted infectious agents (TTIs; hepatitis B virus [HBV], HIV, human T-cell lymphotropic virus types I and II, hepatitis C virus [HCV]). Subsequently, progressive implementation of nucleic acid–amplification technology (NAT) screening for HIV, HCV, and HBV has reduced the residual risk of infectious-window-period donations, such that per unit risks are &lt;1 in 1 000 000 in the United States, other high-income countries, and in high-incidence regions performing NAT. NAT screening has emerged as the preferred option for detection of newer TTIs including West Nile virus, Zika virus (ZIKV), and Babesia microti. Although there is continual need to monitor current risks due to established TTI, ongoing challenges in blood safety relate primarily to surveillance for emerging agents coupled with development of rapid response mechanisms when such agents are identified. Recent progress in development and implementation of pathogen-reduction technologies (PRTs) provide the opportunity for proactive rather than reactive response to blood-safety threats. Risk-based decision-making tools and cost-effectiveness models have proved useful to quantify infectious risks and place new interventions in context. However, as evidenced by the 2015 to 2017 ZIKV pandemic, a level of tolerable risk has yet to be defined in such a way that conflicting factors (eg, theoretical recipient risk, blood availability, cost, and commercial interests) can be reconciled. A unified approach to TTIs is needed, whereby novel tests and PRTs replace, rather than add to, existing interventions, thereby ameliorating cost and logistical burden to blood centers and hospitals.
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DUFF, PATRICK. "Prevention of Opportunistic Infections in Women With HIV Infection." Clinical Obstetrics and Gynecology 62, no. 4 (2019): 816–22. http://dx.doi.org/10.1097/grf.0000000000000483.

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Henning, Margaret, and Sunil K. Khanna. "Overburden, Stigma, and Perceived Agency: Teachers as HIV Prevention Educators in Urban Zambia." AIMS Public Health 3, no. 2 (2016): 265–73. http://dx.doi.org/10.3934/publichealth.2016.2.265.

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Auvinen, Jaana, Jari Kylmä, Maritta Välimäki, Max Bweupe, and Tarja Suominen. "Views of Luba-Kasai Men, Zambia, about Prevention of HIV Transmission to Babies." Public Health Nursing 32, no. 5 (2014): 498–507. http://dx.doi.org/10.1111/phn.12153.

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47

Vinikoor, Michael J., Edford Sinkala, Belinda Chihota, Annie Kanunga, and Gilles Wandeler. "Hepatitis B Therapy as HIV Prevention in Africa: A Case Series From Zambia." Hepatology 69, no. 1 (2018): 458–60. http://dx.doi.org/10.1002/hep.30183.

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Bonawitz, Rachael, Kathleen Lucy McGlasson, Jeanette L. Kaiser, et al. "Maternity Waiting Home Use by HIV-positive Pregnant Women in Zambia: Opportunity for Improved Prevention of Maternal to Child Transmission of HIV." International Journal of MCH and AIDS (IJMA) 8, no. 1 (2019): 1–10. http://dx.doi.org/10.21106/ijma.267.

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Background: Maternity waiting homes (MWHs), defined as residential lodging near health facilities, are an intervention to improve access to maternal care recommended by the World Health Organization. Little is known about utilization of MWHs by HIV-positive women. This paper describes: 1) maternal awareness and utilization of MWHs in rural Zambia among HIV-positive women, and 2) health outcomes for HIVpositive women and their infants with regards to utilization of MWHs. Methods: Data were collected from recently delivered women (delivered after 35 weeks in the previous 12 months) living >9.5 km from 40 health facilities in rural Zambia. For our analysis, primary outcomes were compared between self-identified HIV-positive and HIV-negative women in the sample. Primary outcomes include: 1) awareness of MWHs and 2) utilization of MWHs. We summarized simple descriptive statistics, stratified by maternal self-reported HIV status. We conducted bivariate analyses using chi-square tests, t-tests and Wilcoxon rank sum test. Results: Among 2,381 women, 50 (2.4%) self-identified as HIV-positive. HIV-positive women were older and had more pregnancies and children than HIV-negative women (p<0.001). There was no difference in awareness of MWHs, but HIV-positive women were more likely to use a MWH than HIV-negative women. There was no difference in receipt of infant antiretroviral prophylaxis between women who did or did not stay at a MWH. Conclusion and Global Health Implications: Though HIV prevalence in this sample was lower than expected, MWHs may represent a useful strategy to improve prevention of mother to child transmission of HIV in high prevalence, low-resource settings. Key words: Maternity waiting homes • HIV • PMTCT • Zambia
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Montgomery, Catherine M. "Making prevention public: The co-production of gender and technology in HIV prevention research." Social Studies of Science 42, no. 6 (2012): 922–44. http://dx.doi.org/10.1177/0306312712457707.

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This paper brings together the study of transnational flows in global health and the gendering of technological artefacts. It does so through a case study of vaginal microbicides for HIV prevention, which have commonly been advocated for as a tool for women’s empowerment in parts of the world where HIV is most prevalent, namely sub-Saharan Africa. Drawing on fieldwork in the UK and Zambia, I argue that there is nothing inherently gendered about this ‘woman-controlled’ technology. Combining the notions of scripting and ‘making things public’, I demonstrate the political nature of transnational technology design and testing in the field of sexual health. Rather than framing this in terms of ethical debates, as is frequently the case in studies about the ‘global South’, I ground the analysis in the scripting and de-scripting of technologies and users. By focusing on how things are made public in HIV prevention, I draw attention to the normative, transformative and political potentials of new technologies, such as microbicides, and discuss the implications for their therapeutic success.
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Parham, Groesbeck P., Mulindi H. Mwanahamuntu, Vikrant V. Sahasrabuddhe, et al. "Implementation of cervical cancer prevention services for HIV-infected women in Zambia: measuring program effectiveness." HIV Therapy 4, no. 6 (2010): 713–22. http://dx.doi.org/10.2217/hiv.10.52.

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