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Article: Implementation of HIV pre-exposure prophylaxis for women of color: Perspectives from healthcare providers and staff from three clinical settings.

Kimmel, Allison L / Messersmith, Lisa J / Bazzi, Angela R / Sullivan, Meg M / Boudreau, Jacqueline / Drainoni, Mari-Lynn

Journal of HIV/AIDS & social services

2021 Volume 19, Issue 4, Page(s) 299–319

Abstract: Women of color (WOC) account for 83% of new HIV infections among women in the United States. While pre-exposure prophylaxis (PrEP) is a safe, effective HIV prevention method for women, WOC are less likely to be prescribed PrEP than other populations. ... ...

Abstract	Women of color (WOC) account for 83% of new HIV infections among women in the United States. While pre-exposure prophylaxis (PrEP) is a safe, effective HIV prevention method for women, WOC are less likely to be prescribed PrEP than other populations. Guided by an implementation science research framework, we investigated the implementation of a PrEP initiative for WOC in a US city with high HIV incidence. Across three clinical sites, only three WOC were prescribed PrEP after one year. Analysis of qualitative interviews with clinic staff and providers identified time constraints, reluctance to prescribe PrEP, and discomfort with counseling as implementation barriers. Implementation facilitators included staff and leadership support for PrEP, alignment of PrEP services with organizational missions, and having a centralized PrEP Coordinator. By addressing these identified implementation barriers and facilitators, clinic staff and providers can ensure that WOC are provided with the full range of HIV prevention options.
Language	English
Publishing date	2021-02-22
Publishing country	United States
Document type	Journal Article
ISSN	1538-1501
ISSN	1538-1501
DOI	10.1080/15381501.2021.1887038
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Article ; Online: Poor power quality is a major barrier to providing optimal care in special neonatal care units (SNCU) in Central India.

Messersmith, Lisa J / Ladha, Alyana / Kolhe, Cherryl / Patel, Archana / Summers, James S / Rao, Sowmya R / Das, Prabir / Mohammady, Marym / Conant, Emily / Ramanathan, Nithya / Hibberd, Patricia L

Gates open research

2022 Volume 6, Page(s) 58

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2022-04-27
Publishing country	United States
Document type	Journal Article
ISSN	2572-4754
ISSN (online)	2572-4754
DOI	10.12688/gatesopenres.13479.1
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Article ; Online: High levels of used syringe use and unsafe sex among people who inject drugs in Kumasi, Ghana: an urgent call for a comprehensive harm reduction approach.

Messersmith, Lisa J / Adjei, Rose / Beard, Jennifer / Bazzi, Angela R / Earlywine, Joel J / Darko, Edwin / Agyarko-Poku, Thomas / Asafo, Mabel Kissiwah / Bempah, Sherry Adoma / Adu-Sarkodie, Yaw

Harm reduction journal

2021 Volume 18, Issue 1, Page(s) 62

Abstract: Background: Drug use is a growing concern in Ghana. People who inject drugs (PWID) are highly vulnerable to HIV and other infectious diseases. Ghana's National Strategic Plan for HIV/AIDS 2016-2020 identifies PWID as a key population, but efforts to ... ...

Abstract	Background: Drug use is a growing concern in Ghana. People who inject drugs (PWID) are highly vulnerable to HIV and other infectious diseases. Ghana's National Strategic Plan for HIV/AIDS 2016-2020 identifies PWID as a key population, but efforts to address the needs of PWID have lagged behind those targeting sex workers and men who have sex with men. Lack of information about PWID is a critical barrier to implementing effective HIV prevention and treatment. We aimed to learn more about the vulnerability of the PWID population in order to inform much-needed harm reduction interventions. Methods: From April to July 2018, we conducted a mixed methods study in Kumasi, Ghana, to identify all major drug using locations, count the numbers of PWID to obtain rough population size estimations, and administer anonymous surveys to 221 PWID regarding drug use and sexual behavior. We also tested for HIV, HCV, and HBV from syringes used by survey participants. Results: Key informants identified five major drug using locations and estimated the total PWID population size to be between 600 and 2000. Enumerators counted between 35 and 61 individuals present at each of the five bases. Sharing syringes and reusing discarded syringes are common practices. Over half of survey participants (59%) reported past-month syringe sharing (34% used a used syringe and 52% gave away a used syringe). Individuals with higher injection frequency (≥ 21 times weekly) and who injected with four or more people had higher odds of syringe sharing. Of the survey participants reporting sex in the last month (23%), most reported having one partner, but only 12% used condoms. Nearly all women (11/13) reported exchanging sex for drugs and 6/13 reported exchanging sex for money in the last six months. Fifteen percent of participants (all men) reported paying for sex using drugs or money. Of the used syringes, prevalence estimates were 3% (HIV), 2% (HCV), and 9% (HBV). Conclusions: Our findings confirm the urgent need to implement harm reduction interventions targeting PWID and to build a strong and enabling legal and policy environment in Ghana to support these efforts.
MeSH term(s)	Female ; Ghana/epidemiology ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Harm Reduction ; Homosexuality, Male ; Humans ; Male ; Needle Sharing ; Pharmaceutical Preparations ; Risk-Taking ; Sexual and Gender Minorities ; Substance Abuse, Intravenous/epidemiology ; Syringes ; Unsafe Sex
Chemical Substances	Pharmaceutical Preparations
Language	English
Publishing date	2021-06-10
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2146691-9
ISSN	1477-7517 ; 1477-7517
ISSN (online)	1477-7517
ISSN	1477-7517
DOI	10.1186/s12954-021-00510-7
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Article ; Online: Prevention and Mitigation of Intimate-Partner Violence: The Role of Community Leaders in Tanzania.

Simmons, Elizabeth / Halim, Nafisa / Servidone, Maria / Steven, Ester / Reich, Naomi / Badi, Lilian / Holmes, Nelson / Kawemama, Philbert / Messersmith, Lisa J

Violence against women

2019 Volume 26, Issue 3-4, Page(s) 359–378

Abstract: Intimate-partner violence (IPV) is a major public health issue that disproportionately affects women, especially in Tanzania where 40% of women report experiencing IPV. While IPV research has focused on IPV victims and perpetrators, community leaders can ...

Abstract	Intimate-partner violence (IPV) is a major public health issue that disproportionately affects women, especially in Tanzania where 40% of women report experiencing IPV. While IPV research has focused on IPV victims and perpetrators, community leaders can provide valuable insight on IPV at the community level. We conducted 50 key informant interviews with community leaders in nine villages in the Karatu district. These leaders identified common themes regarding IPV causes and consequences, reporting methods, and future recommendations. This information can help mitigate IPV at the community level in future interventions and shows community leaders themselves could be powerful tools in future IPV programming.
MeSH term(s)	Adult ; Aged ; Alcohol Drinking/epidemiology ; Community Participation ; Disclosure ; Female ; HIV Infections/epidemiology ; Humans ; Income ; Interviews as Topic ; Intimate Partner Violence/prevention & control ; Leadership ; Male ; Middle Aged ; Public Health ; Residence Characteristics ; Social Stigma ; Tanzania
Language	English
Publishing date	2019-03-21
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2031375-5
ISSN	1552-8448 ; 1077-8012
ISSN (online)	1552-8448
ISSN	1077-8012
DOI	10.1177/1077801219832923
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Article ; Online: Real-time Feedback to Improve HIV Treatment Adherence in Pregnant and Postpartum Women in Uganda: A Randomized Controlled Trial.

Sabin, Lora L / Simmons, Elizabeth / Halim, Nafisa / Hamer, Davidson H / Gifford, Allen L / West, Rebecca L / Larson, Anna / Bonawitz, Rachael / Aroda, Philip / Banigbe, Bolanle / Holderman, Alayna J / Murray, Lisa / DeSilva, Mary B / Gasuza, Julia / Mukasa, Barbara / Messersmith, Lisa J

AIDS and behavior

2022 Volume 26, Issue 12, Page(s) 3834–3847

Abstract: We assessed an intervention aimed at improving adherence to antiretroviral therapy (ART) among pregnant and postpartum women living with HIV (PPWLH). We randomized 133 pregnant women initiating ART in Uganda to receive text reminders generated by real ... ...

Abstract	We assessed an intervention aimed at improving adherence to antiretroviral therapy (ART) among pregnant and postpartum women living with HIV (PPWLH). We randomized 133 pregnant women initiating ART in Uganda to receive text reminders generated by real time-enabled electronic monitors and data-informed counseling through 3 months postpartum (PPM3) or standard care. Intention-to-treat analyses found low adherence levels and no intervention impact. Proportions achieving ≥95% adherence in PPM3 were 16.4% vs. 9.1% (t = -1.14, p = 0.26) in intervention vs. comparison groups, respectively; 30.9% vs. 29.1% achieved ≥80% adherence. Additional analyses found significant adherence declines after delivery, and no effect on disease progression (CD4-cell count, viral load), though treatment interruptions were significantly fewer in intervention participants. Per-protocol analyses encompassing participants who used adherence monitors as designed experienced better outcomes, suggesting potential benefit for some PPWLH. The study was registered on ClinicalTrials.Gov (NCT02396394).
MeSH term(s)	Female ; Humans ; Pregnancy ; Anti-HIV Agents/therapeutic use ; HIV Infections/psychology ; Feedback ; Uganda/epidemiology ; Treatment Adherence and Compliance ; Viral Load ; Postpartum Period ; Medication Adherence/psychology
Chemical Substances	Anti-HIV Agents
Language	English
Publishing date	2022-06-15
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	1339885-4
ISSN	1573-3254 ; 1090-7165
ISSN (online)	1573-3254
ISSN	1090-7165
DOI	10.1007/s10461-022-03712-7
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Article: Impact of a Maternal Prevention of Mother-to-child Transmission of HIV (PMTCT) Intervention on HIV-exposed Infants in Uganda.

Murillo, Anays / DeSilva, Mary Bachman / Sabin, Lora L / Halim, Nafisa / Chemusto, Harriet / Aroda, Philip / Gasuza, Julia / Hamer, Davidson H / Williams, Anna Larson / Mukasa, Barbara / Messersmith, Lisa J / Bonawitz, Rachael

International journal of MCH and AIDS

2020 Volume 9, Issue 3, Page(s) 320–329

Abstract: Background: Uganda has successfully reduced pediatric HIV infections through prevention of mother-to-child transmission of HIV (PMTCT) programs, yet little is known about adherence to infant-specific components of interventions. We hypothesized that ... ...

Abstract	Background: Uganda has successfully reduced pediatric HIV infections through prevention of mother-to-child transmission of HIV (PMTCT) programs, yet little is known about adherence to infant-specific components of interventions. We hypothesized that infants born to mothers receiving the WiseMama (WM) electronic drug monitoring (EDM)-based adherence intervention would have increased uptake of six-week post-natal nevirapine (NVP) infant prophylaxis and better adherence to six-week early infant diagnosis (EID) HIV testing. Methods: At two sites in Uganda, the Wise Infant Study (WIN) prospectively followed an infant cohort. Infants were born to women enrolled in an RCT testing the effect of real-time reminders delivered via EDM on maternal adherence to antiretroviral therapy. We assessed intrapartum and discharge receipt of NVP prophylaxis using pharmacy and infant HIV DNA testing laboratory data. Results: Of 121 women eligible for WIN, 97 (80%) consented and enrolled; 46 had been randomized to control and 51 to intervention. There were no differences in receipt of a six-week NVP supply (control 87%, intervention 82%, p = 0.53). Receipt of any NVP prophylaxis did not vary by delivery location (p = 0.35), and although 12% of infants were delivered at non-study health facilities, they were not less likely to receive NVP at discharge (p = 0.37). Among infants with a completed HIV test, there was no difference in mean time to first test (control 52 days (SD 18), intervention 51 days (SD 15), p = 0.86). Only one infant, in the control group, tested positive for HIV. Conclusion and global health implications: We found no significant differences in adherence to infant PMTCT practices between intervention and control infants with relatively high rates of NVP receipt albeit with suboptimal adherence to six-week EID testing. Further work is needed to ensure improved access, uptake, and follow-up of HIV-exposed infants in the Option B+ era.
Language	English
Publishing date	2020-07-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	2715876-7
ISSN	2161-864X ; 2161-8674
ISSN (online)	2161-864X
ISSN	2161-8674
DOI	10.21106/ijma.380
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Article ; Online: Childhood Trauma, Gender Inequitable Attitudes, Alcohol Use and Multiple Sexual Partners: Correlates of Intimate Partner Violence in Northern Tanzania.

Messersmith, Lisa J / Halim, Nafisa / Steven Mzilangwe, Ester / Reich, Naomi / Badi, Lilian / Holmes, Nelson Bingham / Servidone, Maria / Simmons, Elizabeth / Kawemama, Philbert

Journal of interpersonal violence

2017 Volume 36, Issue 1-2, Page(s) 820–842

Abstract: Intimate partner violence (IPV), including physical, sexual, emotional, and economic violence, has profound immediate and long-term effects on individuals and communities worldwide. To date, few studies have focused on couples' reporting of IPV. The aim ... ...

Abstract	Intimate partner violence (IPV), including physical, sexual, emotional, and economic violence, has profound immediate and long-term effects on individuals and communities worldwide. To date, few studies have focused on couples' reporting of IPV. The aim of this article is to present the results of a survey of couples' reporting of IPV and the individual, interpersonal, and social correlates of IPV in northern Tanzania. Four hundred fifty couples from Karatu District, Tanzania, completed a questionnaire measuring attitudes on gender norms and relations, men's experience of childhood trauma, and men's perpetration and women's experience of IPV. We found high levels of acceptance and experience of IPV: 72% of men justified a husband's perpetration of IPV, and 54% of men and 76% of women said that a woman should tolerate violence to keep her family together. The majority of women had ever experienced IPV (77.8%), and 73.6% and 69% had experienced IPV in the past 12 and 3 months, respectively. Men were significantly less likely to report that they had committed IPV: 63.6% ever, 48.9% in the past 12 months, and 46.2% in the past 3 months. Multivariate logistic regression found that younger men, men who reported gender inequitable attitudes, childhood trauma, multiple sexual partners, and alcohol use were significantly more likely to report IPV perpetration in the past 3 months. Younger women, and women with low levels of education and reported food shortages were significantly more likely to report IPV in the past 3 months. These results indicate that social and individual acceptance and justification of IPV are common. Experience of violence persists over time in many relationships. This study demonstrates the need for interventions that address individual-, interpersonal-, and community-level determinants of IPV, including attitudes regarding gender equity, exposure to violence as children and intergenerational violence, lack of education, and poverty.
MeSH term(s)	Attitude ; Child ; Cross-Sectional Studies ; Female ; Humans ; Intimate Partner Violence ; Male ; Risk Factors ; Sexual Partners ; Tanzania/epidemiology
Language	English
Publishing date	2017-09-13
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2028900-5
ISSN	1552-6518 ; 0886-2605
ISSN (online)	1552-6518
ISSN	0886-2605
DOI	10.1177/0886260517731313
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Article ; Online: Together to end violence against women in Tanzania: Results of a pilot cluster randomized controlled trial to evaluate preliminary effectiveness of interpersonal and community level interventions to address intimate partner violence.

Halim, Nafisa / Steven Mzilangwe, Ester / Reich, Naomi / Badi, Lilian / Simmons, Elizabeth / Servidone, Maria / Bingham Holmes, Nelson / Kawemama, Philbert / Messersmith, Lisa J

Global public health

2019 Volume 14, Issue 12, Page(s) 1653–1668

Abstract: In Tanzania, women suffer high rates of intimate partner violence (IPV). We conducted a pilot cluster randomised controlled trial to test the feasibility, acceptability and preliminary effectiveness of IPV prevention interventions targeting men and ... ...

Abstract	In Tanzania, women suffer high rates of intimate partner violence (IPV). We conducted a pilot cluster randomised controlled trial to test the feasibility, acceptability and preliminary effectiveness of IPV prevention interventions targeting men and communities in nine villages randomly assigned to one of three study arms (
MeSH term(s)	Adult ; Female ; Humans ; Interviews as Topic ; Intimate Partner Violence/prevention & control ; Intimate Partner Violence/statistics & numerical data ; Male ; Men/education ; Pilot Projects ; Tanzania/epidemiology
Language	English
Publishing date	2019-05-13
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't ; Video-Audio Media
ZDB-ID	2234129-8
ISSN	1744-1706 ; 1744-1692
ISSN (online)	1744-1706
ISSN	1744-1692
DOI	10.1080/17441692.2019.1609062
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Article ; Online: Retention in HIV Care Among HIV-Seropositive Pregnant and Postpartum Women in Uganda: Results of a Randomized Controlled Trial.

Sabin, Lora L / Halim, Nafisa / Hamer, Davidson H / Simmons, Elizabeth M / Jonnalagadda, Sivani / Larson Williams, Anna / Chemusto, Harriet / Gifford, Allen L / Bonawitz, Rachael / Aroda, Philip / DeSilva, Mary / Gasuza, Julia / Mukasa, Barbara / Messersmith, Lisa J

AIDS and behavior

2020 Volume 24, Issue 11, Page(s) 3164–3175

Abstract: We tested an intervention that aimed to increase retention in antiretroviral therapy (ART) among HIV-positive pregnant and postpartum women, a population shown to be vulnerable to poor ART outcomes. 133 pregnant women initiating ART at 2 hospitals in ... ...

Abstract	We tested an intervention that aimed to increase retention in antiretroviral therapy (ART) among HIV-positive pregnant and postpartum women, a population shown to be vulnerable to poor ART outcomes. 133 pregnant women initiating ART at 2 hospitals in Uganda used real time-enabled wireless pill monitors (WPM) for 1 month, and were then randomized to receive text message reminders (triggered by late dose-taking) and data-informed counseling through 3 months postpartum or standard care. We assessed "full retention" (proportion attending all monthly clinic visits and delivering at a study facility; "visit retention" (proportion of clinic visits attended); and "postpartum retention" (proportion retained at 3 months postpartum). Intention-to-treat and per protocol analyses found that retention was relatively low and similar between groups, with no significant differences. Retention declined significantly post-delivery. The intervention was unsuccessful in this population, which experiences suboptimal ART retention and is in urgent need of effective interventions.
MeSH term(s)	Adult ; Anti-HIV Agents/therapeutic use ; Counseling ; Female ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Humans ; Patient Acceptance of Health Care ; Postpartum Period ; Pregnancy ; Pregnancy Complications, Infectious/drug therapy ; Pregnancy Complications, Infectious/virology ; Pregnant Women ; Retention in Care ; Treatment Outcome ; Uganda/epidemiology
Chemical Substances	Anti-HIV Agents
Language	English
Publishing date	2020-09-09
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	1339885-4
ISSN	1573-3254 ; 1090-7165
ISSN (online)	1573-3254
ISSN	1090-7165
DOI	10.1007/s10461-020-02875-5
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Article ; Online: Drug use and sexual behavior: the multiple HIV vulnerabilities of men and women who inject drugs in Kumasi, Ghana.

Messersmith, Lisa J / Adjei, Rose / Beard, Jennifer / Agyarko-Poku, Thomas / Wondergem, Peter / Falconer, Ariel / Sabin, Lora / Adu-Sarkodie, Yaw

Journal of acquired immune deficiency syndromes (1999)

2015 Volume 68 Suppl 2, Page(s) S124–30

Abstract: Background: Recent evidence suggests that injecting drug use presents a new challenge to HIV prevention in West Africa. Very little is known about the HIV vulnerability of people who inject drugs (PWID) in Ghana, and no HIV prevention efforts are ... ...

Abstract	Background: Recent evidence suggests that injecting drug use presents a new challenge to HIV prevention in West Africa. Very little is known about the HIV vulnerability of people who inject drugs (PWID) in Ghana, and no HIV prevention efforts are currently targeting PWID. Methods: Purposive sampling was used to recruit 30 (20 men and 10 women) PWID to participate in in-depth interviews in Kumasi, Ghana. Transcripts were coded and analyzed by theme. Results: Half the men and more than half the women in this study reported sharing needles/syringes (N/S); most shared a common mixing container; and all said they shared N/S with intimate partners. Some PWID who said that they do not share N/S with other PWID, also said they routinely use N/S that they find on the ground at injecting sites or in the hospital dumpster. Nearly, all the women (9/10) and more than half the men (12/20) were currently sexually active; most had more than 1 partner in the last 6 months, but very few reported condom use. Three women said they exchanged sex for money and 3 men reported buying sex in the last year. Several PWID had no knowledge of HIV transmission through injecting. Conclusions: PWID in Kumasi are highly vulnerable to HIV because of N/S sharing and reuse, lack of condom use, low knowledge of HIV transmission, and lack of services. Program and policy recommendations include N/S and condom distribution, peer education, opioid substitution therapy, and training of health providers, police, and pharmacy staff.
MeSH term(s)	Adolescent ; Adult ; Condoms ; Female ; Ghana/epidemiology ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Needle Sharing ; Prevalence ; Risk Factors ; Sexual Behavior ; Substance Abuse, Intravenous ; Young Adult
Language	English
Publishing date	2015-03-11
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	645053-2
ISSN	1944-7884 ; 1077-9450 ; 0897-5965 ; 0894-9255 ; 1525-4135
ISSN (online)	1944-7884 ; 1077-9450
ISSN	0897-5965 ; 0894-9255 ; 1525-4135
DOI	10.1097/QAI.0000000000000445
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