South Africa consists of many cultural groups who manage pregnancy and lactation differently. Infant nutrition is one of the most important practices to promote life and reduce the escalating infant mortality rate. Globally, around 1.5 million women living with HIV become pregnant each year. Without antiretroviral drugs, up to 40% of their babies will also be infected with HIV. Regardless of all the efforts of giving Antiretroviral Therapy (ART) to HIV positive pregnant women, babies are still infected with HIV; children aged 0-4 years living with HIV face the highest risk of AIDS-related death compared with all other age groups because HIV progresses quickly in babies. The purpose of the study was to explore the factors contributing to non-compliance with feeding practices by HIV positive women in South Africa. A non-probability purposive sampling was used. The target population was females who are HIV positive nursing mothers on ART. Thirty nursing mothers between 20 and 35 years took part in the study. A qualitative research method was used. In-depth individual interviews were used for data collection. Tesch’s approach was used for data analysis. Two themes emerged from the study, namely: • Community reactions regarding infant feeding • Physical problems experienced by mothers who are breastfeeding as some of the influential factors regarding infant feeding practices Conclusion: Promoting the use of correct infant feeding options by HIV positive mothers and other members in the communities will lessen infant morbidity.

Mobile phones remain a largely untapped resource in the ongoing challenge to address Female Sex Worker (FSW) health, including HIV prevention services, in India. An important step towards designing effective mobile phone-based initiatives for FSWs is clarifying the contextual influences of mobile phone solicitation on sexual risk behavior. In this paper, we extend previously identified associations between mobile phone solicitation and condom practices by examining whether this association is moderated by sex work pay and offer key considerations for future research and implementation. Specifically, we conducted an analysis among 589 Indian FSWs, where FSWs who did not use mobile phones to solicit clients had the lowest mean sex work pay (INR 394/ USD 6.54) compared to FSWs who used both mobile and traditional strategies (INR 563/ USD 9.34). Our analysis demonstrated low paid FSWs who used mobile phones concurrently with traditional strategies had 2.46 times higher odds of inconsistent condom use compared to low paid FSWs who did not use mobile phones for client solicitation. No such effect was identified among high paid FSWs. These findings also identified group level differences among FSWs reporting different mobile phone solicitation strategies, including violence, client condom use and HIV status. Our results indicate that low pay does moderate the association between mobile phone solicitation and condom practices, but only among a sub-set of low paid FSWs. These findings also demonstrate the utility of classification by different mobile phone solicitation strategies for accurate assessment of sexual risk among mobile phone soliciting FSWs. In turn, this paves the way for novel approaches to utilize mobile phones for FSW HIV prevention. We discuss one such example, a mobile phone-based rapid screening tool for acute HIV infection targeting Indian FSWs.

Background: HIV prevalence in urban populations of Men who have Sex with Men (MSM) in Vietnam has increased sharply in recent years. Owing to the confluence of both complex sexual partnering and high risk sexual practices, Male Sex Workers (MSW) are at especially high risk for both acquisition and transmission of HIV and other STIs. Methods: We developed, implemented and evaluated a Sexual Health Promotion intervention to engage MSW in health services (including routine testing for STIs and HIV). We implemented the intervention among MSW in Hanoi and Ho Chi Minh City, Vietnam, including pre- and post-intervention assessments of STI/HIV knowledge (n=200). Results: Overall, STI/HIV knowledge increased by 17.3% (p<0.001). All groups of participants showed improved STI/HIV knowledge following the intervention. However, those with the lowest knowledge scores at pre-intervention showed the greatest gains at post-test, so much so that between group disparities in STI/HIV knowledge at pre-test were eliminated following the intervention. Conclusion: Sexual Health Promotion is a promising intervention for increasing STI/HIV knowledge in MSW, and reducing knowledge disparities in this vulnerable population.

Background: Despite high HIV prevalence amongst key populations in strategic travel corridors in Nigeria, there is still very low access to HIV and Sexual Reproductive Health (SRH) services. Targeting men-who-have-sex-with-men, females who sell sex, long distance truck drivers and those who live along the country’s transport corridors is vital for effective control of the HIV epidemic in Nigeria. Excellence and Friends Management Consult (EFMC) partnered with the Nigerian National Agency for the Control of AIDS (NACA) to improve access to HIV, SRH services educate and test for HIV, and offer referral/treatment to HIV-infected individuals. We report on the need, process and outcome of this project. Methods: The Strategic Travelers Outreach Program (STOP) took place between February and August 2016 in Sagamu/Ogere and Obollo-Afor travel corridors. Through community advocacy and outreach, house-to-house, door-to-door and community/office testing, key populations were provided with targeted HIV, SRH and referral services. Results: Over 50,000 people were contacted with HIV and SRH education/counselling. 19,275 (M: 10,965, 56.9%; F: 8,310, 43.1%) were tested with all receiving their results same day. General positivity rate was 1.3%: female (1.9%). Brothel-based female sex workers had higher positivity rate (3.2%). The study also revealed prostitutes did not use condoms with their husbands or long-term boyfriends and that knowledge of HIV was poor. Conclusion: The results highlight an urgent need to mobilize educational and healthcare resources to mitigate HIV transmission along these corridors. A socio-anthropological approach is required to alter long-held beliefs and change risk-seeking behavior.

Background: The spread of HIV/AIDS in the productive age group especially among adolescents is public health concern in Ethiopia. Pre-college students are more venerable to the spread of HIV/AIDS due to different factors. The aim of this study was to assess risky sexual behaviors and associated factors among Mizan, Bonga and Tepi preparatory school students, southwestern, Ethiopia, 2016. Methods: Institution based cross-sectional study was conducted by employing both quantitative and qualitative data collection method from November 1 to December 30, 2016. Systematic random sampling technique was employed for study participant selection. Quantitative data was collected by self-administer questionnaire whereas an in-depth interview was used for qualitative data. Descriptive, logistic regression analysis was performed during data analysis. Results: The overall risky sexual behavior was found to be 25.2% (119 out of 473). Living away from their parent, students who did not attend religious programs, alcohol drinkers, pornography watchers and monthly family income less than 900 birr were found to be predictors of risky sexual behavior of the participants. Conclusion: This study revealed that there is a risky sexual behavior among Mizan, Bonga and Tepi preparatory school students. Therefore responsible bodies should take the initiative to bring about healthy sexual behaviors among school youths.

Individuals living with HIV often reveal their diagnosis to someone at some point in their life. This review examines factors that affect disclosure in different countries and the impact of disclosure on relationships and individual’s well-being. In addition, some countries have required individuals to disclose their diagnosis to their spouse or sexual partners during the initial stages of diagnosis or prior to engaging in sexual behaviour. Research studies involving countries with mandatory disclosure laws are discussed to examine their influences on individuals with HIV and whether the laws are effective in promoting safe sex behaviours. Lastly, implications of using the specific model of disclosure theory to examine the role of the mandatory disclosure as a mediating process in affecting the disclosure outcomes and areas of future research are proposed.

Aim: To identify the factors associated with non-adherence to Antiretroviral Treatment (ART) amongst adult patients at a hospital in Namibia. Methods: Quantitative and qualitative approaches were employed, study sample of 112 adults aged 21 years and older at Keetmanshoop District State Hospital participated. Adherence to ART was assessed using the pill count and self-report methods. A questionnaire with a Cronbach value of 0.8 was used. Census and multi-stage sampling was applied. Data was collected from August to September 2016 through structured interviews and patients records review. Correlation of variables was done to remove multicollinearity. Stata version 12 was used for logistic regression to do univariate and multivariate analysis to determine factors associated with missing five or more doses. Results: In the univariate analysis the following factors were associated with missing five or more doses: Viral load OR: 5.6, 95%CI: 2.0-16.0, Employment OR: 3.3, 95%CI: 1.5-7.2, Taking active substance OR: 2.5, 95%CI: 1.3-4.7 and Emotional status OR: 1.6, 95%CI: 1.02-2.6. The ART stocks seemed adequate as the OR for out of stock did not lead to missed doses (OR: 0.6, 95%CI: 0.4-0.9). Factors such as gender, education, religion and marital status were not associated with missing five or more doses. After multivariate logistic regression the following factors were associated with missing five or more doses; Taking substance adjusted OR: 3.3, 95%CI: 1.4-7.6; WHO clinical stages 2 and 3 adjusted ORs and 95%CIs: 4.1 (1.2-13.8) and 6.1(1.5-25.1) respectively and viral load adjusted OR: 6.3, 95%CI: 2.1-18.7. Reasons mentioned by respondents for missed doses included forgetting, alcohol use, poor access to care, work commitments, lack of food, stress and travelling. Of the 112 respondents in the study, 86.6% had unsuppressed viral loads. Conclusion: Recommendations includes reinforcing use of reminders, automated SMS, establishing treatment supporters and collaborative efforts in reducing active substance use to improve patient adherence.

This is the story of Akanksha, a young college going girl, who was tricked into prostitution and who eventually got infected with Human Immunodeficiency Virus (HIV). She was born in a less privileged household in the suburbs of Kanpur, a city in the northern state of India. Her story brings into light the ways in which Anti-Retroviral Therapy (ART) centers are not only providing preventive medications to those living with HIV, but they are a source of information to the unaware. They play a significant role in slackening the spread of HIV. These centers are opening the doors of communication among the People Living with HIV/AIDS (PLWHA). The protagonist in the story below explicitly narrates her journey from home to prostitution in search of a good life. She further discusses her expectations from ART center from a PLWHA perspective. The story below is not only a demonstration of how ART centers influence the lives of PLWHAs but it is also a testament of what PLWHAs require apart from the preventive medication and awareness programs.