7 results on '"Kapiga, Saidi"'
Search Results
2. The Value of Site Preparedness Studies for Future Implementation of Phase 2/lIb/IIl HIV Prevention Trials Experience From the HPTN 055 Study.
- Author
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Ramjee, Gita, Kapiga, Saidi, Weiss, Stephen, Peterson, Leigh, Leburg, Corey, Kelly, Cliff, and Masse, Benoit
- Subjects
- *
CLINICAL trials , *AIDS prevention - Abstract
The article discusses a study which examines site preparedness for phase 2/IIb/III HIV prevention trials. The sites studied are Durban and Hlabisa in South Africa, Lusaka in Zambia and Moshi in Tanzania. Preparatory studies provide accurate local estimates of HIV incidence, recruitment and retention rates, and behavioral characteristics of targeted populations.
- Published
- 2008
- Full Text
- View/download PDF
3. Exploring the feasibility and acceptability of integrating screening for gender-based violence into HIV counselling and testing for adolescent girls and young women in Tanzania and South Africa.
- Author
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Colombini M, Scorgie F, Stangl A, Harvey S, Ramskin L, Khoza N, Mashauri E, Baron D, Lees S, Kapiga S, Watts C, and Delany-Moretlwe S
- Subjects
- Adolescent, Adult, Counseling, Feasibility Studies, Female, Humans, South Africa, Tanzania, Young Adult, Gender-Based Violence, HIV Infections diagnosis, HIV Infections prevention & control, Pre-Exposure Prophylaxis
- Abstract
Background: Gender-based violence (GBV) undermines HIV prevention and treatment cascades, particularly among women who report partner violence. Screening for violence during HIV testing, and prior to offering pre-exposure prophylaxis (PrEP) to HIV uninfected women, provides an opportunity to identify those at heightened HIV risk and greater potential for non-adherence or early discontinuation of PrEP. The paper describes our experience with offering integrated GBV screening and referral as part of HIV counselling and testing. This component was implemented within EMPOWER, a demonstration project offering combination HIV prevention, including daily oral PrEP, to young women in South Africa and Tanzania., Methods: Between February 2017 and March 2018, a process evaluation was conducted to explore views, experiences and practices of stakeholders (study participants and study clinical staff) during implementation of the GBV screening component. This article assesses the feasibility and acceptability of the approach from multiple stakeholder perspectives, drawing on counselling session observations (n = 10), in-depth interviews with participants aged 16-24 (n = 39) and clinical staff (n = 13), and notes from debriefings with counsellors. Study process data were also collected (e.g. number of women screened and referred). Following a thematic inductive approach, qualitative data were analysed using qualitative software (NVivo 11)., Results: Findings show that 31% of young women screened positive for GBV and only 10% requested referrals. Overall, study participants accessing PrEP were amenable to being asked about violence during HIV risk assessment, as this offered the opportunity to find emotional relief and seek help, although a few found this traumatic. In both sites, the sensitive and empathetic approach of the staff helped mitigate distress of GBV disclosure. In general, the delivery of GBV screening in HCT proved to be feasible, provided that the basic principles of confidentiality, staff empathy, and absence of judgment were observed. However, uptake of linkage to further care remained low in both sites., Conclusion: Most stakeholders found GBV screening acceptable and feasible. Key principles that should be in place for young women to be asked safely about GBV during HIV counselling and testing included respect for confidentiality, a youth-friendly and non-judgmental environment, and a functioning referral network.
- Published
- 2021
- Full Text
- View/download PDF
4. Women design their own vaginal microbicide trial: Suggestions on how to improve adherence from former participants of HIV prevention trials.
- Author
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Miller L, Morar N, Kapiga S, Ramjee G, and Hayes R
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- Administration, Intravaginal, Adult, Aged, Anti-HIV Agents therapeutic use, Anti-Infective Agents therapeutic use, Fear, Female, Humans, Middle Aged, Research Design, South Africa, Tanzania, Young Adult, Anti-HIV Agents administration & dosage, Anti-Infective Agents administration & dosage, HIV Infections prevention & control, Patient Acceptance of Health Care, Patient Compliance psychology, Randomized Controlled Trials as Topic
- Abstract
Low adherence in vaginal microbicide clinical trials for HIV prevention has impeded interpretation of trial results and hindered evaluation of potentially efficacious HIV prevention gels. Understanding the underlying reasons why women join trials and their barriers to product use can support identification of ways to improve adherence and its reporting. Eight focus group discussion workshops were conducted with 46 former microbicide trial participants in Durban, South Africa and Mwanza, Tanzania. Participants provided feedback on why women join trials, the barriers to using study gel and reporting adherence accurately, and how clinical trial design can be improved to support better adherence and its reporting. Women join microbicide trials for a number of important reasons such as healthcare and financial reimbursement. Fear of adverse effects from the investigational product was the most important reason why participants reported not using the gel. The key reason for inaccurate reporting of gel use was fear of removal from the trial. Participants made concrete suggestions for improving microbicide trial design such as applicator use testing and real time feedback, improving education to participants about how trials answer their research questions, and improving transparency and clarity about study procedures. Participants also gave feedback on an innovative trial design with a non-randomised arm. Identifying HIV prevention products for women requires better understanding of the lives of women asked to join these trials, and application of that understanding to microbicide trial design. This study has demonstrated that participants and research teams can work collaboratively to design clinical trials that meet needs of both the research and of participants., Competing Interests: The authors have declared that no competing interests exist.
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- 2021
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- View/download PDF
5. Prevention, Partners, and Power Imbalances: Women's Views on How Male Partners Affected Their Adherence to Vaginal Microbicide Gels During HIV Prevention Trials in Africa.
- Author
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Miller L, Morar N, Kapiga S, Ramjee G, and Hayes R
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- Administration, Intravaginal, Adult, Anti-HIV Agents therapeutic use, Female, Gels, Humans, Interpersonal Relations, Interviews as Topic, Male, Patient Acceptance of Health Care, Sexual Behavior, South Africa, Tanzania, Vaginal Creams, Foams, and Jellies, Anti-Infective Agents, Local administration & dosage, HIV Infections prevention & control, HIV-1, Medication Adherence, Pre-Exposure Prophylaxis methods, Sexual Partners psychology
- Abstract
Background: Low adherence has contributed to disappointing results for trials testing vaginal microbicides for HIV prevention. This study engaged former gel trial participants to understand the reasons behind low adherence and seek suggestions on how to improve products and adherence to microbicides. This analysis examines the impact of participant perceptions of male partners on participant adherence and suggestions on how to address those issues., Methods: Eight focus group discussion workshops were conducted with 46 former microbicide trial participants in South Africa and Tanzania. Participants provided feedback on why women join trials, barriers to using gels and reporting adherence accurately, and how adherence and adherence reporting can be improved., Results: Participants reported that male partners can affect women's ability to use gels. For some, the lubricating effects caused relationship conflicts due to suspicion of male partners about infidelity. Needing to provide sex to partners on demand was a barrier to gel use. Participants suggested a gel formulation which was thicker and less noticeable, and explicit male partner engagement to enhance understanding of the purpose of the gels., Conclusions: The imbalance of power in intimate relationships affects the ability of women to use microbicides as directed. To improve adherence to HIV prevention methods within trials and for successful rollout of proven HIV prevention methods in populations, it is important that the complicated dynamics of sex and relationships be taken into greater consideration and that women receive targeted support to navigate product use and communication within the context of these gender dynamics.
- Published
- 2020
- Full Text
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6. Plasma viral loads during early HIV-1 infection are similar in subtype C- and non-subtype C-infected African seroconverters.
- Author
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Campbell MS, Kahle EM, Celum C, Lingappa JR, Kapiga S, Mujugira A, Mugo NR, Fife KH, Mullins JI, and Baeten JM
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- Adult, Africa, Eastern, Black People, Disease Transmission, Infectious prevention & control, Female, HIV Infections prevention & control, HIV Infections virology, HIV-1 classification, HIV-1 genetics, Humans, Male, Middle Aged, Prospective Studies, RNA, Viral blood, Sensitivity and Specificity, South Africa, Time Factors, Viremia virology, env Gene Products, Human Immunodeficiency Virus genetics, gag Gene Products, Human Immunodeficiency Virus genetics, HIV Infections blood, HIV Seropositivity virology, HIV-1 pathogenicity, Viral Load
- Abstract
Recent data suggest that infection with human immunodeficiency virus type 1 (HIV-1) subtype C results in prolonged high-level viremia (>5 log10 copies/mL) during early infection. We examined the relationship between HIV-1 subtype and plasma viremia among 153 African seroconverters. Mean setpoint viral loads were similar for C and non-C subtypes: 4.36 vs 4.42 log10 copies/mL (P = .61). The proportion of subtype C-infected participants with viral loads >5 log10 copies/mL was not greater than the proportion for those with non-C infection. Our data do not support the hypothesis that higher early viral load accounts for the rapid spread of HIV-1 subtype C in southern Africa.
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- 2013
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7. Transmission of HIV-1 infection in sub-Saharan Africa and effect of elimination of unsafe injections.
- Author
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Schmid GP, Buvé A, Mugyenyi P, Garnett GP, Hayes RJ, Williams BG, Calleja JG, De Cock KM, Whitworth JA, Kapiga SH, Ghys PD, Hankins C, Zaba B, Heimer R, and Boerma JT
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- Adolescent, Adult, Africa South of the Sahara epidemiology, Age Distribution, Child, Child, Preschool, Equipment Contamination statistics & numerical data, Female, HIV Infections prevention & control, Humans, Injections standards, Injections, Intramuscular adverse effects, Injections, Intramuscular standards, Male, Middle Aged, Needles standards, Prevalence, Sex Distribution, South Africa epidemiology, Equipment Contamination prevention & control, HIV Infections transmission, HIV-1 isolation & purification, Injections adverse effects, Needles virology
- Abstract
During the past year, a group has argued that unsafe injections are a major if not the main mode of HIV-1 transmission in sub-Saharan Africa. We review the main arguments used to question the epidemiological interpretations on the lead role of unsafe sex in HIV-1 transmission, and conclude there is no compelling evidence that unsafe injections are a predominant mode of HIV-1 transmission in sub-Saharan Africa. Conversely, though there is a clear need to eliminate all unsafe injections, epidemiological evidence indicates that sexual transmission continues to be by far the major mode of spread of HIV-1 in the region. Increased efforts are needed to reduce sexual transmission of HIV-1.
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- 2004
- Full Text
- View/download PDF
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