Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-3 (of 3 Records) |
Query Trace: Shodell D[original query] |
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How can the health system retain women in HIV treatment for a lifetime? A discrete choice experiment in Ethiopia and Mozambique
Kruk ME , Riley PL , Palma AM , Adhikari S , Ahoua L , Arnaldo C , Belo DF , Brusamento S , Cumba LI , Dziuban EJ , El-Sadr WM , Gutema Y , Habtamu Z , Heller T , Kidanu A , Langa J , Mahagaja E , McCarthy CF , Melaku Z , Shodell D , Tsiouris F , Young PR , Rabkin M . PLoS One 2016 11 (8) e0160764 INTRODUCTION: Option B+, an approach that involves provision of antiretroviral therapy (ART) to all HIV-infected pregnant women for life, is the preferred strategy for prevention of mother to child transmission of HIV. Lifelong retention in care is essential to its success. We conducted a discrete choice experiment in Ethiopia and Mozambique to identify health system characteristics preferred by HIV-infected women to promote continuity of care. METHODS: Women living with HIV and receiving care at hospitals in Oromia Region, Ethiopia and Zambezia Province, Mozambique were shown nine choice cards and asked to select one of two hypothetical health facilities, each with six varying characteristics related to the delivery of HIV services for long term treatment. Mixed logit models were used to estimate the influence of six health service attributes on choice of clinics. RESULTS: 2,033 women participated in the study (response rate 97.8% in Ethiopia and 94.7% in Mozambique). Among the various attributes of structure and content of lifelong ART services, the most important attributes identified in both countries were respectful provider attitude and ability to obtain non-HIV health services during HIV-related visits. Availability of counseling support services was also a driver of choice. Facility type, i.e., hospital versus health center, was substantially less important. CONCLUSIONS: Efforts to enhance retention in HIV care and treatment for pregnant women should focus on promoting respectful care by providers and integrating access to non-HIV health services in the same visit, as well as continuing to strengthen counseling. |
Evaluation of performance and acceptability of two rapid oral fluid tests for HIV detection in Mozambique
Sema Baltazar C , Raposo C , Jani IV , Shodell D , Correia D , Goncalves da Silva C , Kalou M , Patel H , Parekh B . J Clin Microbiol 2014 52 (10) 3544-8 Simplified HIV testing based on oral fluid (OF) may allow the expansion of HIV counseling and testing (CT) while reducing the risk due to exposure to sharps and blood collection. This study evaluated the performance and acceptability of two OF tests (OraQuick Advance HIV-1/2 and Chembio DPP HIV-1/2), compared with the national testing algorithm in Mozambique from May to September 2009 in two CT sites in Maputo City. OF testing was conducted in parallel with national HIV algorithm based on whole blood. Blood samples were collected as dried blood spot (DBS) specimens from all participants for quality assurance. HIV results were delivered according to the national algorithm. According to the national HIV algorithm 512 (30.5%) were reactive, 1151 (68.7%) were non-reactive, and 13 (0.8%) were discordant. All discordant cases were re-tested with enzyme immunoassay followed by Western blot, and five (38.5%) were confirmed as HIV positive. OraQuick showed 518 (30.9%) reactive, and 1158 (69.1%) non-reactive, with sensitivity and specificity of 99.8% and 99.8%, respectively. Chembio DPP OF test showed 519 (31.0%) reactive and 1157 (69.0%) non-reactive with sensitivity and specificity of 100% and 99.8%, respectively. Participants perceived blood testing (49.9%) to be more accurate than OF testing (46.8%). OF testing showed high performance for the diagnosis of HIV infection when examined individually as well as in an algorithm, compared with the national testing algorithm. |
HIV risk perception and behavior among sex workers in three major urban centers of Mozambique
Langa J , Sousa C , Sidat M , Kroeger K , McLellan-Lemal E , Belani H , Patel S , Shodell D , Shodell M , Benech I , Needle R . PLoS One 2014 9 (4) e94838 HIV risk perceptions and behaviors of 236 commercial sex workers from three major Mozambican urban centers were studied using the International Rapid Assessment, Response and Evaluation (I-RARE) methodology. All were offered HIV testing and, in Maputo, syphilis testing was offered as well. Sixty-three of the 236 opted for HIV testing, with 30 (48%) testing positive for HIV. In Maputo, all 30 receiving HIV tests also had syphilis testing, with 6 (20%) found to be positive. Results include interview excerpts and qualitative results using I-RARE methodology and AnSWR-assisted analyses of the interviews and focus group sessions. |
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