Search

BackgroundBesides access to medical male circumcision, HIV testing, access to condoms and consistent condom use are additional strategies men can use to prevent HIV acquisition. We examine male behavior toward testing and condom use.ObjectiveTo determine factors associated with never testing for HIV and consistent condom use among men who never test in Soweto.MethodsA cross-sectional survey in Soweto was conducted in 1539 men aged 18-32 years in 2007. Data were collected on socio-demographic and behavioral characteristics to determine factors associated with not testing and consistent condom use.ResultsOver two thirds (71%) of men had not had an HIV test and the majority (55%, n = 602) were young (18-23). Of those not testing, condom use was poor (44%, n = 304). Men who were 18-23 years (aOR: 2.261, CI: 1.534-3.331), with primary (aOR: 2.096, CI: 1.058-4.153) or high school (aOR: 1.622, CI: 1.078-2.439) education, had sex in the last 6 months (aOR: 1.703, CI: 1.055-2.751), and had ≥1 sexual partner (aOR: 1.749, CI: 1.196-2.557) were more likely not to test. Of those reporting condom use (n = 1036, 67%), consistent condom use was 43% (n = 451). HIV testing did not correlate with condom use.ConclusionLow rates of both condom use and HIV testing among men in a high HIV prevalence setting are worrisome and indicate an urgent need to develop innovative behavioral strategies to address this shortfall. Condom use is poor in this population whether tested or not tested for HIV, indicating no association between condom use and HIV testing.

Problem Voluntary counselling and testing (VCT) data from the registered sites in Kenya have been fraught with challenges, leading to insufficient statistics in the national office for planning purposes. An exercise was carried out to determine the barriers to the flow of data in VCT sites in Kenya. Approach A record-based survey was conducted at 332 VCT sites in Kenya. Data from on-site records were compared with those in the national office. The exercise was conducted in 2004 between 5 September and 15 October. Local setting All registered VCT sites in Kenya. Relevant changes After the exercise, various measures to enhance VCT data collection and reporting were implemented. They include the provision of a uniform data collection and reporting tool to all the districts in the country, the strengthening of a feedback mechanism to update provinces and districts on their reporting status and increased support to the data component of the national quality assurance for VCT. Lessons learned Periodical field visits by the national officials to offer on-the-job training about data management to data collectors and to address data quality issues can dramatically improve the quality and completeness of VCT reports. The perceived relevance of the data and the data collection process to those working at the sites is the critical factor for data quality and timeliness of reporting. Bulletin of the World Health Organization 2007;85:315-318, Une traduction en francais de ce resume figure a la fin de l'article. Al final del articulo se facilita una traduccion al espanol. Resumen Problema Los datos sobre el asesoramiento y pruebas voluntarias (APV) obtenidos en los centros registrados en Kenya presentan muchas deficiencias, lo que impide que la oficina nacional disponga de estadisticas suficientes a efectos de planificacion. Se emprendio un trabajo para determinar los factores que obstaculizaban el flujo de los datos en los centros de APV en Kenya. Metodos Se llevo a cabo un estudio de los registros de 332 centros de APV de Kenya. Los datos de los registros in situ se compararon con los de la oficina nacional. El trabajo se realizo en 2004, entre el 5 septiembre y el 15 de octubre. Contexto local Todos los centros de APV registrados en Kenya. Cambios destacables Terminado el trabajo se implantaron diversas medidas para mejorar la recopilacion y notificacion de los datos de APV. Entre ellas cabe citar el suministro de un instrumento de recogida y notificacion de datos uniforme a todos los distritos del pais, el refuerzo de un mecanismo de retroinformacion para poner al dia a las provincias y los distritos acerca de su situacion en cuanto a la notificacion, y un mayor apoyo al componente de datos del sistema nacional de garantia de la calidad para el APV. Experiencia adquirida Las visitas periodicas al terreno a cargo de funcionarios nacionales para ofrecer a los encargados de recoger los datos formacion en el empleo sobre la gestion de los datos y para abordar aspectos de la calidad de los mismos permiten mejorar extraordinariamente la calidad y la completud de los informes sobre el APV. La importancia asignada a los datos y ai proceso de recopilacion de datos por quienes trabajan en los centros es el factor mas decisivo para asegurar la calidad de los datos y la puntualidad de las notificaciones. Resume Problematique Le recueil de donnees a partir des sites de conseil et de depistage agrees du Kenya s'effectue tres difficilement, d'ou une insuffisance des statistiques reunies au niveau national a des fins de la planification. Un exercice a ete pratique pour identifier les obstacles s'opposant a la circulation des donnees au niveau des sites de conseil et de depistage volontaire kenyans. Demarche appliquee Une enquete a ete menee a partir des dossiers tenus par 332 sites de conseil et de depistage volontaire kenyans. Les donnees tirees des dossiers ont ete comparees avec celles dont dispose le Bureau national des statistiques. L'exercice a ete realise en 2004, du 5 septembre au 15 octobre. Contexte local Tous les sites de conseil et de depistage volontaire agrees du Kenya. Modifications interessantes apportees A I'issue de I'exercice, diverses mesures visant a ameliorer la collecte et la transmission des donnees par ces sites ont ete mises en place. Parmi ces mesures, figuraient l'introduction d'un outil de collecte et de transmission homogenes des donnees dans tous les districts du pays, le renforcement du mecanisme d'information en retour, destine a renseigner les provinces et les districts sur leur situation en matiere de notification, et I'apport d'un soutien accru a la composante Qualite des donnees du systeme national d'assurance de la qualite s'appliquant au conseil et au depistage volontaire du VIH. Enseignements tires II est possible d'ameliorer considerablement la qualite et la completude des notifications transmises par les centres de conseil et de depistage en delegant periodiquement des specialistes nationaux dans ces centres afin de former sur place les personnes chargees de recueillir les informations a la gestion des donnees et de resoudre les problemes de qualite affectant ces donnees. La perception par les personnes travaillant dans ces centres de l'interet des donnees qu'ils recueillent et du processus de collecte est determinante pour la qualite de ces donnees et leur notification en temps utile., Introduction The Government of Kenya, with other stakeholders, developed a national HIV/ AIDS strategic plan (1) that identifies strategies to alleviate the spread of HIV/AIDS whose prevalence is estimated at [...]

Alcohol and other drug use is prevalent among peri-urban, South African adolescents. We identified correlates of alcohol and other drug use by gender among adolescents (age = 16–18 years; N = 822) in peri-urban Johannesburg. Interviewer-administered surveys assessed sexual activity, alcohol and other drug use, and relevant psychosocial factors. In separate logistic regression models of alcohol and other drug use stratified by gender, violence exposure and sexual activity were associated with alcohol use for both males and females. For females only, depressive symptoms were associated with drug use. For males only, being older and sexually active were associated with drug use. Substance use interventions for South African adolescents should consider psychological health, sexual health, and tailoring by gender. [ABSTRACT FROM AUTHOR]

Objectives: Adolescents may be appropriate for inclusion in biomedical HIV prevention trials. Adolescents' overall willingness to participate (WTP) in biomedical HIV prevention trials was examined, including after the prematurely discontinued phase IIb HVTN 503/Phambili HIV vaccine trial, in Soweto, South Africa., Methods: An interview-administered cross-sectional survey was conducted among 506 adolescents (16-18 years) between October 2008 and March 2009. The assessment included WTP in HIV prevention trials, sexual and substance use behavior, and related psychosocial constructs. Multivariate logistic regression analyses examined predictors of WTP in biomedical prevention trials., Results: The sample primarily consisted of female participants (n = 298, 59%), and 50% of all participants were sexually active. WTP in general was high (93%), with 75% WTP in a vaccine trial after being informed about the HVTN 503/Phambili trial. Less exposure to stressors [odds ratio (OR): 2.8, confidence interval (CI): 1.3 to 6.3] was associated with adolescents' WTP in HIV biomedical prevention trials overall. Those with less exposure to stressors (OR: 1.7, CI: 1.1 to 2.8) and not sexually active (OR: 2.1, CI: 1.4 to 3.3) were predictive of WTP after the HVTN 503/Phambili trial. A higher number of sexual partners were associated with unwillingness to participate more generally (P = 0.039) and specifically after the HIV vaccine trial (P = 0.0004)., Conclusions: The high level of adolescents' WTP in biomedical prevention trials is encouraging, especially after the prematurely discontinued HVTN 503/Phambili HIV vaccine trial. High-risk youth were less likely to be WTP, although those not yet sexually active were more WTP. Future biomedical HIV prevention trials should address challenges to enrollment of high-risk adolescents who may show less WTP.