Search

The article discusses the impacts of climate change on coastal fishing communities in India, particularly focusing on fishermen's adaptation strategies to address environmental changes such as declining fish catches, rising temperatures, and shifting monsoon patterns. It highlights the stages of climate adaptation, including signal detection, evaluation, and response, using narratives from the People's Archive of Rural India.

Mobile populations such as fisherfolk show high HIV incidence and prevalence. We pilot-tested implementation strategies to enhance pre-exposure prophylaxis (PrEP) uptake and adherence in the context of healthcare outreach events in two mainland fisherfolk communities on Lake Victoria, Uganda from September 2021 to February 2022. The implementation strategies included PrEP adherence supporters (selected from PrEP users' social networks), community workshops (to address misconceptions and stigma, and empower PrEP advocacy), and check-in calls (including refill reminders). PrEP medical records data were collected from 6-months pre-intervention to 6-months post-intervention. Qualitative interviews with 20 PrEP users (10 who continued, 10 who discontinued), 9 adherence supporters, and 7 key partners (providers, community leaders) explored acceptability. Percentages of PrEP initiators (of those eligible) were significantly higher during the intervention (96.5%) than 6-months before the intervention (84.5%), p < 0.0001; percentages of PrEP users who persisted (i.e., possessed a refill) 6-months post-initiation (47.9% vs. 6.7%) and had at least 80% PrEP coverage (based on their medication possession ratio) from the initiation date to 6-months later (35.9% vs. 0%) were higher during versus pre-intervention, p < 0.0001. A comparison fisherfolk community with better healthcare access had lower uptake (78.3%; p < 0.0001) and persistence at 6-months (34.0%; p < 0.001), but higher coverage during the intervention period (70.4%; p < 0.0001). Qualitative data suggested the strategies promoted PrEP use through reduced stigma and misconceptions. The intervention bundle cost was $223.95, $172.98, and $94.66 for each additional person for PrEP initiation, persistence, and coverage, respectively. Enhanced community-based PrEP implementation that fosters a supportive community environment can improve PrEP use in mobile populations without easy access to healthcare. (NCT05084716). [ABSTRACT FROM AUTHOR]

Forage fish, a crucial source of nutrition in developing countries, are, unfortunately, primarily used for fishmeal and aquafeed production for aquaculture, which mainly serves consumers in developed countries. Industrial fish use leaves a meager portion of the catch available for direct human consumption in these fish-producing countries, leading to inflated fish prices locally. Overfishing forage fish due to the needs of the reduction fishery industry disrupts the ecosystem, diminishes the catch of larger fish, such as mackerel, and marginalizes local artisanal fishermen. This article briefly appraises the financial and nutritional impacts of elevated fish prices on low-income consumers in forage-fish-producing countries, drawing attention to the ethical implications of this situation. By reducing the supply to the industry, a hypothetical 10% boost in the annual supply of fresh forage fish to the current global supply of 5 million Mt (metric tons), markets could save consumers annually hundreds of millions of US dollars globally, tens of millions of US dollars nationally, and several dollars for families while improving the nutrition of families that depend on forage fish. The numbers suggest that even a modest supply shift from industry to the supply of forage fish to fresh fish markets could significantly benefit fish-producing nations and consumers. In some countries, such as South Africa, the orders of magnitude of these sums approach those of the entire value of local fish reduction industries. Increased fish prices could be considered involuntary subsidies by low-income consumers to the aquafeed and aquaculture industries. In summary, the current use of captured forage fish in reduction industries and aquaculture warrants further scrutiny, as it inadvertently burdens disadvantaged societies financially and nutritionally. This article proposes using alternative protein sources and cultivating non-carnivorous fish, among several optional measures, to ensure the equitable distribution of forage fish resources.

Abstract Introduction Non-Communicable Diseases (NCDs) place a significant burden on India's healthcare system, accounting for approximately 62% of all deaths in the country in 2017. The southern Indian state - Kerala - has some of the highest rates of NCDs. Within the state, the fisherfolk community has a high prevalence of risk factors such as tobacco use and alcohol consumption. Working in the fisheries industry demands physical exertion, night shifts alongside extended periods of time at sea (for seafaring fisherfolk). Evidence is scant on how these conditions relate to the health-seeking experiences of fisherfolk, particularly in the context of NCDs. We conducted a qualitative study in two districts of Kerala to fill this gap. Methods In-depth individual and small group interviews– as per participant preference – with male and female fishing community members living with NCDs were conducted between October 2022 and February 2023 in two districts of Kerala. Interviews were conducted to explore community members’ experiences with health-seeking for NCDs. Transliterated English transcripts were coded using ATLAS.ti software and analysed using thematic analysis with inductive generation of codes, with indexing against Levesque, Harris, and Russell’s 2013 access to healthcare framework. Results Thirty-three interviews with 42 participants were conducted. We found that NCDs were usually diagnosed late- either when admitted/consulted for other illnesses or when the symptoms became unbearable. Health-seeking patterns differed between seafaring and inland fishing subgroups, who were sampled from two districts in the state. Seafaring fisherfolk preferred public facilities for regular checkups and medicines while in-land fisherfolk relied on private facilities, although it was considered expensive. Ability to seek care was impacted by the working hours of the health centre which did not suit their working hours. Health constaints and related expenses also impacted their financial status and occupation, with some opting for less strenuous jobs. Conclusion This study highlights the NCD-related health-seeking experiences of the fisherfolk community in Kerala, India. Fisherfolk reported self neglect, delayed diagnosis, cost and livelihood constraints owing to the onset of NCDs, even as dual practice and medicine access in the public sector were appreciated. Overall, larger studies and policymaking processes should consider in depth the experiences faced by particular economic groups like fisherfolk, who may face unique health and care-seeking challenges.

Forage fish, a crucial source of nutrition in developing countries, are, unfortunately, primarily used for fishmeal and aquafeed production for aquaculture, which mainly serves consumers in developed countries. Industrial fish use leaves a meager portion of the catch available for direct human consumption in these fish-producing countries, leading to inflated fish prices locally. Overfishing forage fish due to the needs of the reduction fishery industry disrupts the ecosystem, diminishes the catch of larger fish, such as mackerel, and marginalizes local artisanal fishermen. This article briefly appraises the financial and nutritional impacts of elevated fish prices on low-income consumers in forage-fish-producing countries, drawing attention to the ethical implications of this situation. By reducing the supply to the industry, a hypothetical 10% boost in the annual supply of fresh forage fish to the current global supply of 5 million Mt (metric tons), markets could save consumers annually hundreds of millions of US dollars globally, tens of millions of US dollars nationally, and several dollars for families while improving the nutrition of families that depend on forage fish. The numbers suggest that even a modest supply shift from industry to the supply of forage fish to fresh fish markets could significantly benefit fish-producing nations and consumers. In some countries, such as South Africa, the orders of magnitude of these sums approach those of the entire value of local fish reduction industries. Increased fish prices could be considered involuntary subsidies by low-income consumers to the aquafeed and aquaculture industries. In summary, the current use of captured forage fish in reduction industries and aquaculture warrants further scrutiny, as it inadvertently burdens disadvantaged societies financially and nutritionally. This article proposes using alternative protein sources and cultivating non-carnivorous fish, among several optional measures, to ensure the equitable distribution of forage fish resources. [ABSTRACT FROM AUTHOR]

Simple Summary: South Sudan's recent recovery from armed conflict presents an opportunity to address critical conservation issues affecting the country's biodiversity. The protection of the vast Sudd wetlands is vital for the conservation of many different species and habitats and to ensure the continuity and improvement of the lives of human communities living in it. Animal–human conflict, particularly from crocodiles, poses a significant threat to the adequate protection of the Sudd wetlands. Crocodile attacks have resulted in mortality rates ranging from 50% to 100%. To mitigate these conflicts, changing human behaviour through environmental education is key. This can also improve attitudes towards biodiversity conservation, aligning future development with conservation needs. We conducted interviews with fishers to understand resident people's perception of crocodiles. Crocodiles are seen as a threat because they restrict movement along water bodies, attack livestock and humans, and damage fishing equipment. Attitudes are complex, nuanced, and sometimes polarised within communities. They are feared and hated but also valued for their meat and skin. Some interviewees believe that consuming crocodile meat can improve longevity, sexual potency, and protect against witchcraft. While there is a consensus on the need to destroy crocodile breeding habitats, there is also support for establishing protected areas in the Sudd wetlands. Crocodile sanctuaries would help reduce illegal hunting and protect the species, especially with the growing human population and economic development after the civil war. The nuanced attitudes revealed in certain questions provide a valuable foundation for raising awareness and designing more targeted promotional campaigns. Conflicts between human populations and Nile crocodiles are widespread with crocodiles posing significant threats to fisherfolk and riverine communities across r-Saharan Africa. Hundreds of deadly attacks take place annually, and mortality rates may range from 50% to 100%. Attitudes and perceptions towards crocodiles were studied using structured questionnaires among fisherfolk along the River Nile and the Sudd wetlands in South Sudan. Local communities used crocodiles for their meat and skin/leather trades. The meat is regarded to enhance longevity, sexual potency, and protection against witchcraft. Crocodiles are perceived as a main threat to lives and livelihoods as they restrict people's freedom of movement along water bodies, attack livestock and humans, and devastate fishing equipment. To assess whether responses were influenced by the intensity of crocodile threats, published data on fatal crocodile attacks on humans and livestock were analysed using Generalised Linear Models (GLMs). This analysis indicated a direct link between the number of crocodile attacks and human attitudes. Crocodiles were generally feared and hated, and there was the agreement of the need to destroy breeding habitats. However, some attitudes were complex and nuanced as highlighted by the agreement of local communities on the need to destroy Nile Crocodile breeding habitats on the one hand and the need to establish crocodile sanctuaries as the the preferred strategy to mitigate risks and conflict on the other hand. There is a need for the creation of a crocodile sanctuary in the Sudd wetlands to minimise the risks of illegal hunting and to buffer the increasing pressure on crocodiles due to human population growth and economic upturn after the civil war. [ABSTRACT FROM AUTHOR]

In the Global South, small-scale fisheries may be highly influenced by taboos and traditional beliefs that are believed to maintain fishing pressure within sustainable limits, maintain ecosystem balance and mitigate risks associated with work at sea. However, despite their potentially significant role in mediating human-resource interactions, limited attention has been given to taboos in the context of small-scale fisheries. Among the socio-cultural taboos shaping participation in and benefits from fisheries activities, gender-specific taboos are particularly significant. Thus, this paper explores the role of gender taboos in sustainable and equitable small-scale fisheries management in the Global South. It also identifies and assesses the quality and scientific rigor of the key themes from the literature. A systematic literature review was conducted to assess the state of knowledge on taboos and small-scale fisheries and situate the role of gender-specific taboos within small-scale fisheries governance. Over 100 relevant publications were obtained and categorised using scanning and selection methods. The main emerging themes from the literature review included traditional ecological knowledge and taboos, conservation and management taboos, and gender taboos. The findings highlight the significance of taboos in shaping gender dynamics, livelihoods, and food security within small-scale fisheries; however, there remain many gaps in understanding the role of taboos in mediating fishing activities and in maintaining gender inequalities in the fisheries sector. Without this knowledge, gender inequalities could be further exacerbated where taboos are used as a management tool without considering the gender dimensions. This study, therefore, seeks to fill this gap by providing insights for fisheries managers and practitioners for managing fisheries in a way that considers these socio-cultural factors that shape access to, control over and the benefits derived from fisheries. [ABSTRACT FROM AUTHOR]

Background: HIV is hyperendemic among fisherfolk in Sub-Saharan Africa, especially around Lake Victoria, Uganda. Purpose/Research Design: We conducted cross-sectional semi-structured interviews about oral pre-exposure prophylaxis (PrEP) implementation with 35 Ugandan fisherfolk (15 women, 20 men) and 10 key stakeholders (healthcare providers, policymakers, community leaders). We used a directed content analysis approach based on implementation science and social marketing frameworks. Results: Participants showed high acceptability for PrEP. Anticipated barriers among fisherfolk included stigma (due to similar medications/packaging as HIV treatment); misconceptions; mobility, competing needs, poverty, and partner conflict. Anticipated provider barriers included insufficient staffing and travel support. Recommendations included: change PrEP packaging; integrate PrEP with other services; decrease PrEP refill frequency; give transportation resources to providers; train more healthcare workers to provide PrEP to fisherfolk; and use positively framed messages to promote PrEP. Conclusions: Results can inform policymakers and healthcare organizations on how to overcome barriers to PrEP scale-up in most at-risk populations with poor healthcare access. [ABSTRACT FROM AUTHOR]

Abstract Background Ethnobotanical knowledge about the role of plants in fisheries provides valuable ecological information vital for sustainable management of local resources; however, it is diluted and understudied globally. This literature review aims to map the knowledge of plant use within traditional fishing communities. Methods Through the PRISMA method, we identified and selected 34 articles reporting the use of plants in fisheries, and including 344 taxa of plants and algae. Uses of plants and algae were grouped into different categories. Results In the novel categorization of fishery-related uses we proposed, the most mentioned were for fishing and building/repair of fishing artifacts and habitat-related uses, while the records of plants related to fiber uses, providing aid in fishing management and species causing problems, were among the least mentioned. Semi-structured interview is most commonly used with local resource users, especially fishery experts, in exploring perceptions on plant use within traditional fishing communities. Diversity was high in all the recorded families, but most were reported locally. Conclusion Ethnobotanical studies with fishers are not common in the documented literature but they provide a large number of use reports. On the basis this review, in most of the world, the information is of a casual and sporadic nature. Fishers can provide information on aquatic plants and algae that create problems and aid in fishing management, which are crucial in understanding the ecosystem of a region experiencing environmental challenges. This knowledge is greatly understudied globally and undergoing a rapid decline, as highlighted in several of the reviewed articles. Thus, further systematic research on fishery-related uses of plants by fisherfolk is needed considering its potential contribution to the sustainable management of fishery resources.

Abstract Fisheries studies concerning the related impacts of fishing on the aquatic environment have mostly dealt with industrial fisheries. Concerted large‐scale exploitation can lead to stock declines and potentially species extinction. Hydrocynus vittatus is a piscivore and popular recreational fish species that can grow up to 70 cm fork length and weigh up to 15 kg. Hydrocynus vittatus is also a fish of importance in Lake Kariba as local communities along lake shorelines depend on it for both income and food. There is an insufficient understanding of the impacts of artisanal fishing on tigerfish, H. vittatus population parameters and reproductive biology in Lake Kariba. Hence, this study investigated life history traits and population dynamics of H. vittatus in the Ume Basin of Lake Kariba, north‐eastern Zimbabwe. Scales were used to estimate the age of tigerfish and the Bertalanffy growth curve used to estimate the growth parameters. A gonadal reproductive stage determination index was used to determine sexual maturity and the logistic growth curve was used to estimate size at 50% sexual maturity (L50). Using the gonadal maturation index, the L50 for males was estimated ranging between 120 and 149 mm. On the other hand, L50 reached between 250 and 299 mm in females. Females had a higher average mean length (335 mm), compared to that of males (289 mm). The length‐at‐age data from scales had relatively few outliers and moderate scatter. Parameters for the von Bertalanffy growth curve were (L‐infinity = 641.5, k = 0.517, t0 = 3.07). This study highlighted the negative impacts (male‐biased sex ratio and small size at maturity) that artisanal gillnet fishing has on the population structure and reproductive potential of tigerfish in the Ume Basin of Lake Kariba. These impacts are a direct result of both legal and illegal fishing activities of the fishers operating in the Ume Basin and based at Musamba Fishing Camp. There is, therefore, an urgent need for the regulatory authority, the Matusadona Conservation Trust, to engage the fishers in developing long‐term strategies to reverse the observed unhealthy population status and allow the tigerfish stock to replenish itself.

Background: Ethnobotanical knowledge about the role of plants in fisheries provides valuable ecological information vital for sustainable management of local resources; however, it is diluted and understudied globally. This literature review aims to map the knowledge of plant use within traditional fishing communities. Methods: Through the PRISMA method, we identified and selected 34 articles reporting the use of plants in fisheries, and including 344 taxa of plants and algae. Uses of plants and algae were grouped into different categories. Results: In the novel categorization of fishery-related uses we proposed, the most mentioned were for fishing and building/repair of fishing artifacts and habitat-related uses, while the records of plants related to fiber uses, providing aid in fishing management and species causing problems, were among the least mentioned. Semi-structured interview is most commonly used with local resource users, especially fishery experts, in exploring perceptions on plant use within traditional fishing communities. Diversity was high in all the recorded families, but most were reported locally. Conclusion: Ethnobotanical studies with fishers are not common in the documented literature but they provide a large number of use reports. On the basis this review, in most of the world, the information is of a casual and sporadic nature. Fishers can provide information on aquatic plants and algae that create problems and aid in fishing management, which are crucial in understanding the ecosystem of a region experiencing environmental challenges. This knowledge is greatly understudied globally and undergoing a rapid decline, as highlighted in several of the reviewed articles. Thus, further systematic research on fishery-related uses of plants by fisherfolk is needed considering its potential contribution to the sustainable management of fishery resources. [ABSTRACT FROM AUTHOR]

Fisheries studies concerning the related impacts of fishing on the aquatic environment have mostly dealt with industrial fisheries. Concerted large‐scale exploitation can lead to stock declines and potentially species extinction. Hydrocynus vittatus is a piscivore and popular recreational fish species that can grow up to 70 cm fork length and weigh up to 15 kg. Hydrocynus vittatus is also a fish of importance in Lake Kariba as local communities along lake shorelines depend on it for both income and food. There is an insufficient understanding of the impacts of artisanal fishing on tigerfish, H. vittatus population parameters and reproductive biology in Lake Kariba. Hence, this study investigated life history traits and population dynamics of H. vittatus in the Ume Basin of Lake Kariba, north‐eastern Zimbabwe. Scales were used to estimate the age of tigerfish and the Bertalanffy growth curve used to estimate the growth parameters. A gonadal reproductive stage determination index was used to determine sexual maturity and the logistic growth curve was used to estimate size at 50% sexual maturity (L50). Using the gonadal maturation index, the L50 for males was estimated ranging between 120 and 149 mm. On the other hand, L50 reached between 250 and 299 mm in females. Females had a higher average mean length (335 mm), compared to that of males (289 mm). The length‐at‐age data from scales had relatively few outliers and moderate scatter. Parameters for the von Bertalanffy growth curve were (L‐infinity = 641.5, k = 0.517, t0 = 3.07). This study highlighted the negative impacts (male‐biased sex ratio and small size at maturity) that artisanal gillnet fishing has on the population structure and reproductive potential of tigerfish in the Ume Basin of Lake Kariba. These impacts are a direct result of both legal and illegal fishing activities of the fishers operating in the Ume Basin and based at Musamba Fishing Camp. There is, therefore, an urgent need for the regulatory authority, the Matusadona Conservation Trust, to engage the fishers in developing long‐term strategies to reverse the observed unhealthy population status and allow the tigerfish stock to replenish itself. [ABSTRACT FROM AUTHOR]

Conflicts between human populations and Nile crocodiles are widespread with crocodiles posing significant threats to fisherfolk and riverine communities across r-Saharan Africa. Hundreds of deadly attacks take place annually, and mortality rates may range from 50% to 100%. Attitudes and perceptions towards crocodiles were studied using structured questionnaires among fisherfolk along the River Nile and the Sudd wetlands in South Sudan. Local communities used crocodiles for their meat and skin/leather trades. The meat is regarded to enhance longevity, sexual potency, and protection against witchcraft. Crocodiles are perceived as a main threat to lives and livelihoods as they restrict people’s freedom of movement along water bodies, attack livestock and humans, and devastate fishing equipment. To assess whether responses were influenced by the intensity of crocodile threats, published data on fatal crocodile attacks on humans and livestock were analysed using Generalised Linear Models (GLMs). This analysis indicated a direct link between the number of crocodile attacks and human attitudes. Crocodiles were generally feared and hated, and there was the agreement of the need to destroy breeding habitats. However, some attitudes were complex and nuanced as highlighted by the agreement of local communities on the need to destroy Nile Crocodile breeding habitats on the one hand and the need to establish crocodile sanctuaries as the the preferred strategy to mitigate risks and conflict on the other hand. There is a need for the creation of a crocodile sanctuary in the Sudd wetlands to minimise the risks of illegal hunting and to buffer the increasing pressure on crocodiles due to human population growth and economic upturn after the civil war.

In February 2023, an oil tanker carrying 5660 bbl of industrial fuel oil sank off Naujan in the Philippines, causing an oil spill in the waters of Oriental Mindoro and nearby provinces. The disaster affected fishing communities as well as marine ecosystems including the Verde Island Passage, which is at the "center of the world's marine biodiversity". This study assessed the immediate social and economic impacts of this oil spill on various communities of the Naujan coast. We conducted semi-structured interviews and employed a narrative analysis to explore the lived experiences of fisherfolk after the oil spill and to understand the socioeconomic impacts. With the prohibition of fishing and other aquatic activities, the participants lost up to USD 1300 of income per week from fishing. The participants had no other source of income due to the lack of other skills or an opportunity for an alternative livelihood in the community. While the government provided food packs and financial assistance, the participants found these insufficient to sustain their basic family needs including food, utilities, education, and health. Traces of oil were also found in the sources of potable water affecting their daily household activities. The fisherfolk, who live in communities that are vulnerable to natural and human-made hazards, had their subsistence, food security, and human well-being highly compromised. The findings provided recommendations for government interventions to mitigate the impacts of an oil spill and other future disasters, considering social, economic, and human ecological perspectives. [ABSTRACT FROM AUTHOR]

Available guidance to mitigate health risks from exposure to freshwater harmful algal blooms (HABs) is largely derived from temperate ecosystems. Yet in tropical ecosystems, HABs can occur year-round, and resource-dependent populations face multiple routes of exposure to toxic components. Along Winam Gulf, Lake Victoria, Kenya, fisher communities rely on lake water contaminated with microcystins (MCs) from HABs. In these peri-urban communities near Kisumu, we tested hypotheses that MCs exceed exposure guidelines across seasons, and persistent HABs present a chronic risk to fisher communities through ingestion with minimal water treatment and frequent, direct contact. We tested source waters at eleven communities across dry and rainy seasons from September 2015 through May 2016. We measured MCs, other metabolites, physicochemical parameters, chlorophyll a, phytoplankton abundance and diversity, and fecal indicators. We then selected four communities for interviews about water sources, usage, and treatment. Greater than 30% of source water samples exceeded WHO drinking water guidelines for MCs (1μg/L), and over 60% of source water samples exceeded USEPA guidelines for children and immunocompromised individuals. 50% of households reported sole use of raw lake water for drinking and household use, with alternate sources including rain and boreholes. Household chlorination was the most widespread treatment utilized. At this tropical, eutrophic lake, HABs pose a year-round health risk for fisher communities in resource -limited settings. Community-based solutions and site-specific guidance for Kisumu Bay and similarly impacted regions is needed to address a chronic health exposure likely to increase in severity and duration with global climate change.

Fishing communities in Uganda have high rates of excessive alcohol consumption and negative health outcomes related to alcohol consumption, such as HIV acquisition and transmission and intimate partner violence victimization and perpetration. Research lacks understanding of alcohol use in Ugandan fishing communities, underlying reasons for excessive drinking among fishermen or how their community perceives negative health outcomes linked to excessive alcohol consumption. This qualitative study was conducted among Ugandan fisherfolk to determine why excessive alcohol consumption has overtaken their communities. Through analyzing in-depth interviews and focus group discussions, reasons for drinking and community perceptions of drinking were explored using the Socio Ecological Model and the Time Perspective Theory. Interviews were coded into two content themes: social influences on drinking and using alcohol to cope with stress. Participants acknowledged links between excessive alcohol consumption and negative health outcomes within their families and communities. These findings highlight the need for alcohol-related reduction interventions that are sensitive to contextual factors and self-identified contributors to problematic alcohol use within individuals and their communities. Such interventions must consider the social, ecological and economic conditions within fishing sites, focusing not only on individual-level behavioral change but also challenging the underlying structures that foster excessive alcohol consumption.

This study explored the intersection of masculinity and HIV care engagement among fishermen and other male fisherfolk on antiretroviral therapy (ART) in Wakiso District, Uganda. We conducted 30 in-depth interviews with men on ART recruited from HIV treatment sites and used a thematic analysis approach. Since HIV diagnosis and ART initiation, men had adopted masculine identities more conducive to HIV care engagement. The masculine roles of worker and provider, husband and sexual partner and the appearance of physical strength were compromised by HIV, but restored by ART's positive effects on health. Peers also emerged as facilitators to HIV care, with men supporting each other to seek testing and treatment. However, structural and occupational barriers to HIV care associated with the masculine role of worker remained a barrier to care engagement. Findings suggest that emphasising the benefits of ART in bolstering men's ability to fulfil the roles important to them may improve the effectiveness of HIV testing and treatment messaging for men. Differentiated care models that address structural-level barriers to care, and community-level gender-transformative programming to help fishermen engage in HIV care, may be beneficial.

How does decentralization provide good public services among traditional fisherfolk and diminish the exploitation of marine resources? This article discusses the positive impact of decentralization on the patron-client relationship of the fishing community by depicting the articulation of social relations and power relations tied among the fisherfolk Sangkarrang Islands, City of Makassar. By employing the theory of access, this study revealed that the proliferation of the Sub District of Sangkarrang had configured the landscape of socio-political interaction. This condition was restructured by the relation of production among producers and successfully eliminated the over-exploitation of marine resources in Sangkarrang Islands. Social hierarchy became more opened and allowed the vulnerable group to access the services provided by the government. They could also channel their political aspiration without being interfered with by a higher social class. At the same time, the political landscape had been rearranged and control from elites tended to be declined. In conclusion, decentralization had increased democratization for local people and had brought public services to be more efficient, including the decreasing of marine exploitation. [ABSTRACT FROM AUTHOR]

Abstract Background The World Health Organization (WHO) recommends the use of pre-exposure prophylaxis (PrEP) in key populations at elevated risk for exposure to HIV. If used effectively, PrEP can reduce annual HIV incidence to below 0.05%. However, PrEP is not acceptable among all communities that might benefit from it. There is, therefore, a need to understand perceptions of PrEP and factors associated with willingness to use PrEP among key populations at risk of HIV, such as members of communities with exceptionally high HIV prevalence. Objective To examine the perceptions and factors associated with willingness to use oral PrEP among members of fishing communities in Uganda, a key population at risk of HIV. Methods We conducted an explanatory sequential mixed-methods study at Ggaba fishing community from February to June 2019. Survey data were collected from a systematic random sample of 283 community members in which PrEP had not been rolled out yet by the time of we conducted the study. We carried out bivariate tests of association of willingness to use PrEP with demographic characteristics, HIV risk perception, HIV testing history. We estimated prevalence ratios for willingness to use PrEP. We used backward elimination to build a multivariable modified Poisson regression model to describe factors associated with willingness to use PrEP. We purposively selected 16 participants for focus group discussions to contextualize survey findings, analysing data inductively and identifying emergent themes related to perceptions of PrEP. Key results We enrolled 283 participants with a mean age of 31 ± 8 years. Most (80.9%) were male. The majority of participants had tested for HIV in their lifetime, but 64% had not tested in the past 6 months. Self-reported HIV prevalence was 6.4%. Most (80.6, 95%CI 75.5–85.0) were willing in principle to use PrEP. Willingness to use PrEP was associated with perceiving oneself to be at high risk of HIV (aPR 1.99, 95%CI 1.31–3.02, P = 0.001), having tested for HIV in the past 6-months (aPR 1.13, 95%CI 1.03–1.24, P = 0.007), and completion of tertiary education (aPR 1.97, 95%CI 1.39–2.81, P

Background Fishing communities are a subpopulation burdened by human immunodeficiency virus (HIV), mainly due to their mobility and cash income access. Strategies to mitigate the spread of HIV in fishing communities have varying outcomes. We conducted a study to determine the prevalence of HIV, recent infection and associated factors among fishing communities at Lake Victoria in Tanzania. Methods We conducted a cross-sectional study in the first quarter of 2019. The participants' information was collected using a structured questionnaire. Blood samples were screened for HIV infection; the positive samples were tested for avidity and viral load to determine the recent infection. Logistic regression analysis was used to determine the factors associated with HIV infection. Results A total of 1048 individuals were included with a mean age of 34 years (SD ± 11.5). The overall prevalence of HIV was 9.1%, while 7.4% had a recent infection. Lack of formal education, being separated/divorced/widowed, transactional sex, history of sexually transmitted infections, not tested for HIV in the last 12 months had 1.7 to three times more odds of contracting HIV. Conclusion A proportion of HIV recent infection among the fisherfolks was relatively high, signifying the continuous spread, which is predisposed by some demographic and behavioural characteristics. [ABSTRACT FROM AUTHOR]

In February 2023, an oil tanker carrying 5660 bbl of industrial fuel oil sank off Naujan in the Philippines, causing an oil spill in the waters of Oriental Mindoro and nearby provinces. The disaster affected fishing communities as well as marine ecosystems including the Verde Island Passage, which is at the “center of the world’s marine biodiversity”. This study assessed the immediate social and economic impacts of this oil spill on various communities of the Naujan coast. We conducted semi-structured interviews and employed a narrative analysis to explore the lived experiences of fisherfolk after the oil spill and to understand the socioeconomic impacts. With the prohibition of fishing and other aquatic activities, the participants lost up to USD 1300 of income per week from fishing. The participants had no other source of income due to the lack of other skills or an opportunity for an alternative livelihood in the community. While the government provided food packs and financial assistance, the participants found these insufficient to sustain their basic family needs including food, utilities, education, and health. Traces of oil were also found in the sources of potable water affecting their daily household activities. The fisherfolk, who live in communities that are vulnerable to natural and human-made hazards, had their subsistence, food security, and human well-being highly compromised. The findings provided recommendations for government interventions to mitigate the impacts of an oil spill and other future disasters, considering social, economic, and human ecological perspectives.

The Sudd in South Sudan, formed by the White Nile’s Baḥr al-Jabal section, is one of the largest and most important wetlands in the world. Communities in the region almost exclusively depend on fisheries for food and livelihoods. Although threatened by over-exploitation and habitat changes, fish populations are also affected by climate change. Using semi-structured questionnaires, we assessed fisherfolk’s opinions of how recent variation in climate affected their livelihoods and the environment. Fisherfolk perceived that climate had changed in the past decade and were negatively impacted by this. Interviewees reported average higher temperatures, a greater frequency of floods and droughts, unpredictable timing of seasons, and erratic rainfall. Destruction of fishing villages/camps, loss and damage of fishing equipment, shifts in the fishing calendar, reduction of fish trade, and fish catch declines as well as psycho-social problems were given as the major consequences of climate change. Causes of climate change and variability were perceived to be linked to uncontrolled harvest of forest resources, anger of God and ancestors, and natural variability in climate. Most respondents expressed a desire to adopt more responsible behavior such as planting trees and establishing community nurseries, being educated on climate change risks, and sustainable fisheries management. Our results show that fisherfolk in the Sudd are troubled by climate change impacts on their livelihoods and on fish populations. In South Sudan, climate change has been reported from hydroclimatological data but concrete impacts on people remain largely unknown and of little concern because of recent wars and the poor economy. Our study provides an example of how fisherfolks’ local ecological knowledge (LEK) can be used as an early warning system of the negative impacts on livelihoods and fish populations and support adaptation to the changing climate. [ABSTRACT FROM AUTHOR]

Introduction: fisherfolk play a major role in emerging economies such as Ghana. While many fishing communities are noted to be underdeveloped, fisherfolk are considered to neglect their oral hygiene, while being prone to certain conditions due to peculiar risks. The purpose of this study was to determine the periodontal health status of adults in a selected fishing community in Ghana. Methods: a descriptive crosssectional study was carried out to assess the periodontal status of adults in Jamestown, a periurban area in Ghana. Data acquisition was by means of a structured questionnaire and periodontal examination. Information obtained consisted of demographic data (age, sex, education and occupation category) oral hygiene practices (type of teeth cleaning materials, methods of tooth cleansing, frequency of dental visits and reasons for the visit) and periodontal clinical parameters (plaque index, and community periodontal index of treatment needs). Results: a total of 276 participants were included in the study, with ages ranging from 21 to 70 years. The participants were made up of 138 fisherfolk and 138 non-fisherfolk. Males had worse scores for periodontal disease compared to females. Plaque score did not vary among age groups, but changed significantly between educational level and occupational categories. CPITN varied significantly between educational levels, age categories and occupational categories. Conclusion: the study found inhabitants of the fishing community of Jamestown to have a generally unsatisfactory periodontal status, but worse for the fisherfolk in the community. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization (WHO) recommends the use of pre-exposure prophylaxis (PrEP) in key populations at elevated risk for exposure to HIV. If used effectively, PrEP can reduce annual HIV incidence to below 0.05%. However, PrEP is not acceptable among all communities that might benefit from it. There is, therefore, a need to understand perceptions of PrEP and factors associated with willingness to use PrEP among key populations at risk of HIV, such as members of communities with exceptionally high HIV prevalence.Objective: To examine the perceptions and factors associated with willingness to use oral PrEP among members of fishing communities in Uganda, a key population at risk of HIV.Methods: We conducted an explanatory sequential mixed-methods study at Ggaba fishing community from February to June 2019. Survey data were collected from a systematic random sample of 283 community members in which PrEP had not been rolled out yet by the time of we conducted the study. We carried out bivariate tests of association of willingness to use PrEP with demographic characteristics, HIV risk perception, HIV testing history. We estimated prevalence ratios for willingness to use PrEP. We used backward elimination to build a multivariable modified Poisson regression model to describe factors associated with willingness to use PrEP. We purposively selected 16 participants for focus group discussions to contextualize survey findings, analysing data inductively and identifying emergent themes related to perceptions of PrEP.Key Results: We enrolled 283 participants with a mean age of 31 ± 8 years. Most (80.9%) were male. The majority of participants had tested for HIV in their lifetime, but 64% had not tested in the past 6 months. Self-reported HIV prevalence was 6.4%. Most (80.6, 95%CI 75.5-85.0) were willing in principle to use PrEP. Willingness to use PrEP was associated with perceiving oneself to be at high risk of HIV (aPR 1.99, 95%CI 1.31-3.02, P = 0.001), having tested for HIV in the past 6-months (aPR 1.13, 95%CI 1.03-1.24, P = 0.007), and completion of tertiary education (aPR 1.97, 95%CI 1.39-2.81, P < 0.001). In focus group discussions, participants described pill burden, side-effects and drug safety as potential barriers to PrEP use.Conclusions and Recommendations: Oral PrEP was widely acceptable among members of fishing communities in peri-urban Kampala. Programs for scaling-up PrEP for fisherfolk should merge HIV testing services with sensitization about PrEP and also increase means of awareness of PrEP as an HIV preventive strategy . [ABSTRACT FROM AUTHOR]

Abstract Background Depression is a prevalent and serious mood disorder and a major source of disability adjusted life years (DALY) in Uganda. Furthermore, evidence from Uganda and other countries throughout sub-Saharan Africa suggests that nearly a third of persons living with human immunodeficiency virus (HIV) suffer from depression and it adversely affects healthcare seeking behavior. The high burden of disease attributable to depression makes data on the prevalence of depression in Uganda, a country with a generalized HIV epidemic, a public health priority. This paper describes the psychometric properties of the Center for Epidemiologic Studies-Depression (CES-D) measure when administered to men and women residing in three fishing communities along the shore of Lake Victoria. Methods We applied methods based on item response theory and classical test theory approaches to assess individual item characteristics, conducted exploratory factor analysis and assessed internal reliability, and construct and content validity of the measure. All analyses were performed in R Studio. Results The study sample consisted of 300 residents of fishing communities in Wakiso District, Uganda. Fifty-six percent of the sample was female and 19.7% reported being HIV positive. Seven items of the measure that did not perform well, either because they could not differentiate between levels of the latent trait or because they did not map onto the primary factor, were removed from the scale. A single factor structure best fit our final set of 13-items and we found an overall coefficient alpha of 0.89, indicating high internal consistency in this population. Conclusions Based on our findings, we recommend that future use of the CES-D in this population utilize our revised scale with the final set of 13-items. The addition of other measures that can improve the rigor of CES-D validation efforts, such as inclusion of a clinical depression measure and administration in both a clinical and a general population sample in this setting are needed.

Background: Preexposure prophylaxis (PrEP) reduces new human immunodeficiency virus(HIV) infections by up to 96% and is recommended for key populations by the World Health Organization. Understanding the knowledge and willingness to use PrEP is essential for effective implementation. This study assessed these factors and identifiedcharacteristics associated with differences in knowledge among key populations in Kampala, Uganda., Methods: We administered a cross-sectional survey to a systematic sample of 497 participants from fisherfolk (283, 56.9%), men who have sex with men (MSM) (93, 18.7%), and female sex worker (FSW) (121, 24.4%) communities in Kampala Central, where PrEP had not yet been rolled out. Data on sociodemographic characteristics, PrEP awareness, and HIV-related behavioralfactors were collected. Knowledge about PrEP was measured using an adopted questionnaire comprising five key questions about PrEP knowledge, graded as no knowledge, some knowledge and good knowledge. Ordered probit regression models were used to analyze the associations of independent factors with PrEP knowledge levels., Results: Participants had a mean age of 29±7.6 years. Ofthese, 257 (51.7%) reported having sex with women, 157 (31.6%) with men and 83 (16.7%) with both men and women. Self-reported HIV-positive status was 6.4% in fisherfolk, 11.8% in MSM and 27.3% in FSW. PrEP awareness stood at 62.4% overall, with the highest awareness in FSW (73.6%) and the lowest in fisherfolk (54.1%). Willingness to use PrEP was high across all groups (77.7%), although it was lower among FSW (66.9%). Multivariate probit analysis highlighted key independent factors associated with PrEP knowledge among fisherfolks and HIV-related concerns (Adj. Coeff = 0.54, 95% CI: 0.11, 0.97) and lack of PrEP awareness (Adj. Coeff = -0.99, 95% CI:-1.28, -0.70); among MSM, lack of PrEP awareness (Adj. Coeff = -1.74, 95% CI:-2.38, -1.10); and in FSW, tertiary education (Adj. Coeff = 1.53, 95% CI: 0.07, 2.99) and marital status (Adj. Coeff = 0.57, 95% CI=0.09, 1.05). MEshighlighted the influence of these independent factors at each knowledge level., Conclusions and Recommendations: Despite the high willingness to use PrEP, significant knowledge gaps exist, particularly concerning dosage and use duration, which are influenced by factors such as HIV concern and educational attainment. Tailored educational initiatives may bridge these gaps and enhance willingness to use PrEP., Competing Interests: Competing interests The authors declare no conflicts of interest.

This study aimed to analyze the social vulnerability and adaptive capacity of fisherfolk in Garchitorena, Camarines Sur to the impacts of climate change. Following the causal-comparative research design, the quantitative method was employed, and 460 of 1,959 registered fisherfolk were interviewed. Because fisherfolk are exposed and sensitive to climate change impacts, their social vulnerability is high. The study found that those with motorized boats and who have other sources of income are highly vulnerable in terms of demographic and economic factors, whereas fisherfolk with nonmotorized boats are highly vulnerable in terms of social factors. In addition, fisherfolk with nonmotorized boats are far less adaptive economically compared with the others. Furthermore, fisherfolk suffer from different levels of social vulnerability and adaptive capacity to climate change owing to the significant difference found in their presumed attributes. Most of the identified variables are factors influencing the level of social vulnerability of fisherfolk, except for the training activities and seminars attended. The factors influencing the fisherfolk's adaptive capacity to the impacts of climate change are age, household size, years spent in school, monthly per capita income, sources of income, number of household members employed, membership of social groups, distance of dwelling place to disaster-prone areas, and training activities and seminars attended. Therefore, a gender-sensitive investigation based on the concept of this study can be conducted to specifically address the differences and factors that could affect the social vulnerability and adaptive capacity to climate change impacts of male and female fisherfolk. [ABSTRACT FROM AUTHOR]

Fishing along Ghana's coast is the main livelihood for local communities, and it contributes significantly to their incomes. Most of them get employment, food security, and access to better health care through fishing activities. However, the fishing industry has been saddled with many challenges in recent times, which has led to low landings. This study aimed to assess the causes and effects of the decline in fish landings on the livelihood of coastal communities in the Central Region of Ghana. The systematic sampling technique was used to randomly select 200 households from four communities. A questionnaire was designed to elicit information from fisherfolk based on Likert scale estimation. In addition, time-series data of fish landings and imports for 51 years (1976–2017) was used in the analysis. The results from the study indicate that fish landings are declining, and this is affecting the income levels of fisherfolk. However, the impact of income decline on the female fisherfolk is lower as compared to their male counterparts. To mitigate against dwindling incomes, the fisherfolk have adopted livelihood diversification coping strategies. The key livelihood options identified in the communities are masonry, trading, and commercial driving. The fisherfolk mentioned overfishing, pollution, use of smaller mesh size nets, and unapproved methods of fishing as drivers of decline in fish landings. This study recommends that mandated institutions with oversight responsibilities in the fishing industry should be strengthened to enable them to conduct their functions effectively, so, they halt the decline in fish catch. [ABSTRACT FROM AUTHOR]

Men's engagement in the HIV care continuum may be negatively affected by adherence to inequitable gender norms, which may be exacerbated by HIV stigma. This cross-sectional study with 300 male fisherfolk in Uganda examined the independent and interacting effects of inequitable gender norm endorsement and HIV stigma on men's missed HIV care appointments and missed antiretroviral (ARV) doses. Greater gender inequitable norm endorsement was associated with increased odds of missed HIV clinic visits (adjusted odds ratio [AOR)] 1.44, 95% CI 1.16–1.78) and a statistically significant interaction between internalized HIV stigma and inequitable gender norms on missed ARV doses was identified (AOR 5.32, 95% CI 2.60–10.86). Adherence to traditional gender norms reduces men's HIV appointment attendance, and among men with high internalized stigma, increases the likelihood of poor treatment adherence. These findings point to the need for HIV interventions that reconfigure harmful gender norms with a focus on stigma reduction. [ABSTRACT FROM AUTHOR]

HIV fatalism, or the belief that HIV acquisition and mortality is out of one's control, is thought to contribute to HIV risk in fishing populations in East Africa. The objective of this cross-sectional study was to investigate the association between fatalism and sexual risk behaviours (unprotected sex, engagement in transactional sex), beyond the influence of other known HIV risk factors (e.g. food insecurity, mobility), and identify demographic, psychosocial, and structural correlates of HIV fatalism. Ninety-one men and women living in fishing villages on two islands in Lake Victoria, Uganda completed an interviewer-administered questionnaire after testing HIV-positive during home or community-based HIV testing between May and July 2015. Multivariate logistic regression was used to test the association between HIV fatalism and transactional sex and multivariate linear regression was used to identify demographic, psychosocial, and structural correlates of HIV fatalism. HIV fatalism was significantly associated with a greater likelihood of transactional sex (AOR = 3.07, 95% CI = 1.02–9.23, p = 0.04), and structural barriers to HIV care (e.g. distance to clinic) were significantly associated with HIV fatalism (β = 0.26, SE = 0.12, p = 0.04). Our findings highlight HIV fatalism as a contributor to transactional sex in Ugandan fishing communities, and as a product of broader social and contextual factors, suggesting the potential need for structural HIV interventions in this setting.

Abstract Background New HIV infections in Tanzania have been decreasing, however some populations remain at higher risk. Despite of that, evidence on the magnitude of HIV infection and the associated factors and HIV/AIDS services uptake among fisherfolk in Tanzania are inadequately explored. This study therefore aimed at determining prevalence of HIV infection and utilization of HIV/AIDS services among fishfolk in selected Islands of Lake Victoria for evidence-based interventions. Methods Cross-sectional study determining status of HIV infection among fisherfolk (n = 456) and retrospective review of voluntary counselling and testing (VCT) registry (n = 1744) were done in Buchosa and Muleba districts. Structured questionnaire and HIV rapid test kits with the standard testing protocol were used as research tools. Results A total of 269 (58.9%) male and 187 (41.1%) female fisherfolk were recruited during the community survey. Prevalence of HIV infection was 14% in all surveyed landing sites with a site variation from as low as 7.2% to as high as 23.8%. Participants employed in fishing related employment had higher odds of being HIV infected (5.4 times) than those who practiced fishing and partly farming [OR = 5.40; 95%CI 1.88–15.61; p

Antiretroviral treatment (ART) diversion from prescribed to non-prescribed users (i.e., sharing or selling) is an understudied dimension of HIV treatment adherence. We sought to explore ART diversion patterns in high-prevalence fishing communities on Lake Victoria, Uganda. We implemented a qualitative study in two fishing communities on Lake Victoria in south-central Uganda to identify facilitators of and pathways to ART diversion. We conducted 25 semi-structured interviews with HIV-positive fishermen (n = 25) and female sex workers (n = 10) covering personal and community experiences with ART selling/sharing, reasons for medication diversion, and potential solutions to reduce diversion. Data were analyzed using an adapted framework analysis approach. Participants reported frequent ART sharing within occupational networks, but no selling. Mobility was the principal driver of ART sharing and was associated with other barriers to treatment access including stigma, fear of negative health provider interactions, and transportation. ART sharing appears to emerge in response to short-term treatment interruptions in this setting. Future studies should explore characteristics and drivers of ART diversion in other high-burden settings and identify how these practices are correlated with key health outcomes like virologic failure and drug resistance. [ABSTRACT FROM AUTHOR]

The increasing impact of fish and fisheries products on socioeconomic standpoints, in terms of income, employment generation, nutrition value, and many more, benefit the livelihood patterns of many fishing communities in the world. But this is not in the case with the fishing community of the Kashmir valley living along the shores of Wular Lake. This fishing community has always remained differentiated and suffered low esteem in the social hierarchy. This community forms the artisanal/traditional fisheries of the Kashmir valley and supplies the bulk of fish consumed by the native residents. This artisanal fishing community forms a most neglected group and often finds itself outside the mainstream of economic, social, and political activities. This research was carried out to study the present livelihood status of the fishing community of the Kashmir valley. The data was collected from two villages, Zurimanz, in the Bandipora district and Ghat, in the Baramulla district. [ABSTRACT FROM AUTHOR]

Development has often been equated with modernization and urbanization, as reflected in government development programs such as the Cebu Integrated Area Development Master Plan (CIADMP). One of the flagship projects under the CIADMP is the 330.9-hectare Cebu South Reclamation Project (CSRP) formulated by foreign consultants, local government authorities, and the business sector. Underlying these indicators of economic development that encourage such projects, urban fishing communities have been uprooted from their livelihoods that are reliant on the sea subsequently reclaimed by the project. This study focuses on how the affected fisherfolk in Cebu City changed their household provisioning strategies as a result of the CSRP. The study primarily utilized ethnographic research methodologies, including key informant interviews, focus group discussions, deep hanging out, and field observation. Newspaper research and secondary data analysis were likewise done to supplement field data. Findings are based on the narratives of the affected residents, which show that prior to the CSRP, primary livelihood strategies of most residents revolved around small-scale fishing practices: panawom (diving/spear fishing), pamasol (hook and line fishing), pamukot (fishing using mesh nets), panginhas (gleaning), and panu (gathering shrimps and crabs at low tide). The implementation of the CSRP has adversely affected their livelihood, leading them to shift to less lucrative and mostly informal, irregular, temporary service-related work. Strategies employed were not only in terms of livelihood options but also in tapping social networks, pooling resources, cutting on consumption costs, and joining resistance movements. [ABSTRACT FROM AUTHOR]

In-depth interviews were conducted with 42 HIV-positive fisherfolk and 15 health care providers to identify experiences of social support and its influence on access to and use of HIV testing, treatment, and care. Fisherfolk participants reported receiving support at some point. Prior to HIV diagnosis, this usually took the form of advice on what illness they were dealing with and remedies to use. After HIV diagnosis and disclosure to friends or family, emotional support enabled fisherfolk to come to terms with an HIV diagnosis, informational support offered guidance on how best to live with HIV, while instrumental support enabled access to relevant HIV services. Finally, affiliative support, in the form of new friends met through HIV clinic visits, provided a sense of belonging. Each of these different kinds of support assisted fisherfolk to respond positively to HIV with important consequences for secondary and tertiary prevention. [ABSTRACT FROM AUTHOR]

Occupational groups at high-risk of HIV in sub-Saharan Africa (SSA) may be at increased risk of substance use because of occupation-related factors. We synthesised qualitative data on determinants and context of alcohol misuse and illicit drug use in these groups. We systematically searched five databases for qualitative studies reporting on alcohol misuse or illicit drug use in fisherfolk, uniformed personnel, miners, truckers, motorcycle taxi riders, and sex workers in SSA. Qualitative data and interpretations were extracted and synthesised using a systematic iterative process to capture themes and overarching concepts. We searched for papers published prior to January 2018. We identified 5692 papers, and included 21 papers in our review, published from 1993 to 2017. Most studies were conducted among fisherfolk (n = 4) or sex workers (n = 12). Ten papers reported on alcohol use alone, three on illicit drug use alone and eight on both. Substance use was commonly examined in the context of work and risky behaviour, key drivers identified included transactional sex, availability of disposable income, poverty, gender inequalities and work/living environments. Substance use was linked to risky behaviour and reduced perceived susceptibility to HIV. Our review underscores the importance of multilevel, integrated HIV prevention and harm reduction interventions in these settings. [ABSTRACT FROM AUTHOR]

Background: Depression is a prevalent and serious mood disorder and a major source of disability adjusted life years (DALY) in Uganda. Furthermore, evidence from Uganda and other countries throughout sub-Saharan Africa suggests that nearly a third of persons living with human immunodeficiency virus (HIV) suffer from depression and it adversely affects healthcare seeking behavior. The high burden of disease attributable to depression makes data on the prevalence of depression in Uganda, a country with a generalized HIV epidemic, a public health priority. This paper describes the psychometric properties of the Center for Epidemiologic Studies-Depression (CES-D) measure when administered to men and women residing in three fishing communities along the shore of Lake Victoria. Methods: We applied methods based on item response theory and classical test theory approaches to assess individual item characteristics, conducted exploratory factor analysis and assessed internal reliability, and construct and content validity of the measure. All analyses were performed in R Studio. Results: The study sample consisted of 300 residents of fishing communities in Wakiso District, Uganda. Fifty-six percent of the sample was female and 19.7% reported being HIV positive. Seven items of the measure that did not perform well, either because they could not differentiate between levels of the latent trait or because they did not map onto the primary factor, were removed from the scale. A single factor structure best fit our final set of 13-items and we found an overall coefficient alpha of 0.89, indicating high internal consistency in this population. Conclusions: Based on our findings, we recommend that future use of the CES-D in this population utilize our revised scale with the final set of 13-items. The addition of other measures that can improve the rigor of CES-D validation efforts, such as inclusion of a clinical depression measure and administration in both a clinical and a general population sample in this setting are needed. [ABSTRACT FROM AUTHOR]

This study explores the perceptions of the coastal communities of Balochistan vis–à–vis China Pakistan Economic Corridor (CPEC), a mega–development project in Gwadar. Understanding the socioeconomic issues of the vulnerable coastal communities of the province is critical for the policymakers to ensure an inclusive approach towards development planning. The volatile political situation of this province underscores the need to proactively address the socioeconomic impact of CPEC projects on the local populace by including them in the development process instead of allowing them to be marginalized and exploited at the hands of the forces which are averse to the progress. It attempts to map the expectations and apprehensions of the subjects vis–à–vis changes brought about by CPEC in their region, especially how they perceive their habitat and livelihood being impacted–positively or negatively. Finally, the study charts out a set of recommendations based on the first–hand observations, and advocates devising an integrated strategy at all policy levels for ensuring inclusion of these coastal communities as important stakeholders not only in the mega development taking place in the form of CPEC–led development projects but also in the maritime economy and security of Pakistan. [ABSTRACT FROM AUTHOR]

HIV fatalism, or the belief that HIV acquisition and mortality is out of one's control, is thought to contribute to HIV risk in fishing populations in East Africa. The objective of this cross-sectional study was to investigate the association between fatalism and sexual risk behaviours (unprotected sex, engagement in transactional sex), beyond the influence of other known HIV risk factors (e.g. food insecurity, mobility), and identify demographic, psychosocial, and structural correlates of HIV fatalism. Ninety-one men and women living in fishing villages on two islands in Lake Victoria, Uganda completed an interviewer-administered questionnaire after testing HIV-positive during home or community-based HIV testing between May and July 2015. Multivariate logistic regression was used to test the association between HIV fatalism and transactional sex and multivariate linear regression was used to identify demographic, psychosocial, and structural correlates of HIV fatalism. HIV fatalism was significantly associated with a greater likelihood of transactional sex (AOR = 3.07, 95% CI = 1.02–9.23, p = 0.04), and structural barriers to HIV care (e.g. distance to clinic) were significantly associated with HIV fatalism (β = 0.26, SE = 0.12, p = 0.04). Our findings highlight HIV fatalism as a contributor to transactional sex in Ugandan fishing communities, and as a product of broader social and contextual factors, suggesting the potential need for structural HIV interventions in this setting. [ABSTRACT FROM AUTHOR]

We used a discrete choice experiment to assess the acceptability and potential uptake of HIV pre-exposure prophylaxis (PrEP) among 713 HIV-negative members of fishing communities in Uganda. Participants were asked to choose between oral pill, injection, implant, condoms, vaginal ring (women), and men circumcision. Product attributes were HIV prevention effectiveness, sexually transmitted infection (STI) prevention, contraception, waiting time, and secrecy of use. Data were analysed using mixed multinomial logit and latent class models. HIV prevention effectiveness was viewed as the most important attribute. Both genders preferred oral PrEP. Women least preferred the vaginal ring and men the implant. Condom use was predicted to decrease by one third among men, and not to change amongst women. Oral PrEP and other new prevention technologies are acceptable among fishing communities and may have substantial demand. Future work should explore utility of multiple product technologies that combine contraception with HIV and other STI prevention. [ABSTRACT FROM AUTHOR]

Qualitative research exploring the influence of community-level factors on access to and use of HIV treatment and care services among people living in fishing communities is limited, especially with respect to those already in receipt of HIV care and on treatment. To enhance understanding of these issues, semi-structured in-depth interviews were conducted with 42 HIV-positive fisherfolk and 15 health care providers from two HIV clinics located in two fishing communities in Uganda. Fisherfolk's mobility and poor transport systems were significant barriers to access to and use of HIV treatment and care. Mobility, which involved regular movement between communities, sometimes led to fisherfolk's inability to access HIV treatment and care. A poor transport system in fishing communities – characterised by irregular transport services and boats in a poor condition – was reported to force both fisherfolk and health care providers sometimes to cancel journeys to centres providing treatment and support. Community-level factors such as these, which relate to the organisation and provision of transport in local community settings, are significant influences on access to HIV treatment and care. Interventions that address these challenges are needed to improve access to and use of HIV treatment and care in fishing communities. [ABSTRACT FROM AUTHOR]

Fishing communities are a most-at-risk population for HIV in Uganda. Alcohol use and abuse and economic vulnerability fuel risky sexual practices and lead to increased risk of HIV infection in these communities. Economic strengthening is an emerging intervention approach and interventions promoting saving money via mechanisms with a "soft commitment" in the form of restricting or charging small fees for withdrawals, may serve to reduce spending on alcohol and spending that leads to HIV risk behaviors in cash-based economies. However, little research has been conducted to explore the potential for commitment savings-led economic strengthening interventions to address alcohol use and sexual risk behavior among fisherfolk. This cross-sectional study explored the associations between commitment savings, HIV sexual risk behavior, and problematic alcohol among fisherfolk. We also determined whether commitment savings moderated the associations between problematic alcohol use and risky sexual behaviors. 300 (132 male, 168 female) residents of fishing communities on Lake Victoria, Uganda completed a structured interviewer-assisted interview. Over half (55.3%) used commitment savings by saving money in a bank or savings cooperative or via mobile money. Having problematic alcohol use increased the rate of risky unprotected sex with: all partners (adjIRR 6.08, 95% CI 4.30–8.60) and with casual partners and CSWs/clients (adjIRR 4.90, 95% CI 3.09–7.78), and increased the odds of having met a sex partner at an alcohol venue (adjOR 2.84, 95% CI 1.46–5.51) compared to those without problematic alcohol use. Commitment savings was associated with lower odds of: problematic alcohol use (adjOR 0.50, 95% CI 0.26–0.96), meeting a sex partner at an alcohol venue (adjOR 0.43, 95% CI 0.24–0.78), as well as lower rates of risky unprotected sex with all partners (adjIRR 0.68, 95% CI 0.48–0.96), and with causal partners, CSWs/clients (adjIRR 0.38, 95% CI 0.17–0.85). Use of commitment savings moderated the associations between problematic alcohol use and unprotected sex. However, the moderating effects of commitment savings varied by gender. These findings suggest that promoting saving money in savings mechanisms which involve a commitment may be a potentially viable avenue for HIV prevention among fishing communities and may be particularly helpful for those who have problematic alcohol use. [ABSTRACT FROM AUTHOR]

The Sundarbans is the largest mangrove forest in the world, spanning across the borders of Bangladesh and India. It is also a UNESCO World Heritage site recognized for its ecological uniqueness and importance to all humanity. The Sundarbans is home to diverse species and some of the poorest twelve million people in the world. Hindu and Muslim fisherfolk and honey collectors who call this place home share a respect for the forest and venerate Bonbibi (Forest Lady), who they believe reigns over the forest and its inhabitants. For them, she offers protection. This article argues that in their ritual and ethical practices, these Muslims and Hindus treat the Sundarbans as sacred land. It is sacred because it provides all they need to live a sustainable life. This study combines textual analysis of the epic poem about Bonbibi entitled the Jahuranama with ethnographic studies and field visits. [ABSTRACT FROM AUTHOR]

This cross-sectional study assessed determinants of HIV clinic appointment attendance and antiretroviral treatment (ART) adherence among 300 male fisherfolk on ART in Wakiso District, Uganda. Multi-level factors associated with missed HIV clinic visits included those at the individual (age, AOR = 0.98, 95% CI 0.97-0.99), interpersonal (being single/separated from partner, AOR: 1.25, 95% CI 1.01-1.54), normative (anticipated HIV stigma, AOR: 1.55, 95% CI 1.05-2.29) and physical/built environment-level (travel time to the HIV clinic, AOR: 1.11, 95% CI 1.02-1.20; structural-barriers to ART adherence, AOR: 1.27, 95% CI 1.04-1.56; accessing care on a landing site vs. an island, AOR: 1.35, 95% CI 1.08-1.67). Factors associated with ART non-adherence included those at the individual (age, β: − 0.01, η2 = 0.03; monthly income, β: − 0.01, η2 = 0.02) and normative levels (anticipated HIV stigma, β: 0.10, η2 = 0.02; enacted HIV stigma, β: 0.11, η2 = 0.02). Differentiated models of HIV care that integrate stigma reduction and social support, and reduce the number of clinic visits needed, should be explored in this setting to reduce multi-level barriers to accessing HIV care and ART adherence. [ABSTRACT FROM AUTHOR]