Community Health Posts Impact on Adult Male Access to HIV Services in Lusaka, Zambia
Abstract:
Achieving HIV epidemic control is an
ultimate goal for Zambia. To achieve this goal there is need to close services access
gaps. Adult men are less likely to utilize existing health facility-based HIV services
and they account for a significant proportion of new HIV infections with risk to
onward HIV transmission in the community. Almost two-thirds of males
(65.1%) and 79.2% of females aged 15-59 years reported ever having been tested for
HIV and having received their results. Over two-thirds (67.1%) of HIV-positive males
25-29 years of age reported being unaware of their HIV status. Twenty-five percent
of the national pandemic is in Lusaka. This non-experimental, descriptive
mixed-methods study shows increase in number of adult males accessing services at
community health posts and the impact of community health posts on improving adult
male access to HIV services, including improved retention to HIV services and viral
load suppression. The attitude or customer care of health care workers and the location
of the community health posts played a bigger role in improving adult male access
to HIV services, by creating a better, trusted environment and by bringing the services
closer to where these males work or live. The community health post improved also
the inequality in accessing HIV services for adult males, as this is one of the
key factors to achieving the end of HIV pandemic.
References:
[1] United Nations
AIDS. (2020). UNAIDS DATA Report 2020. UNAIDS, (pp. 4-26). https://www.unaids.org/sites/default/files/media_asset/2020_aids-data-book_en.pdf.
Accessed in April 2020.
[2] Zambia Central
Statistical Office (2013). Population and Demographic Projections 2011 - 2035. Central
Statistical Office. https://www.zamstats.gov.zm/phocadownload/Zambia%20Census%20Projection%202011%20-%202035.pdf.
Accessed on August 4th, 2020.
[3] Population-Based
HIV Impact Assessment. (2016). Zambia Population-Based HIV Impact Assessment Report.
(pp. 6-129). https://phia.icap.columbia.edu/wp-content/uploads/2019/03/ZAMPHIA-Final-Report__2.26.19.pdf.
Accessed on August 5th, 2020.
[4] Country
Operational Plan. (2018). Strategic Direction Summary. PEPFAR Zambia. https://www.pepfar.gov/documents/organization/285848.pdf.
Accessed on August 6th, 2020.
[5] World Health
Organization. (2016). Consolidated guidelines on the use of antiretroviral drugs
for treating and preventing HIV infection. World Health Organization. https://www.who.int/hiv/pub/arv/arv-2016/en/.
Accessed on August 6th, 2020.
[6] World Health
Organization. (2017). Treat all: Policy adoption and implementation status in countries.
World Health Organization. https://www.who.int/publications/i/item/treat-all-policy-adoption-and-implementation-status-in-countries.
Accessed on August 7th, 2020.
[7] United Nations
AIDS. (2019). Zambia Country factsheet. UNAIDS. http://aidsinfo.unaids.org/. Accessed
on August 06, 2020.
[8] Sweat M,
Morin S, Celentano D, Mulawa M, Singh B, Mbwambo J, et al. (2011). Community-based
intervention to increase HIV testing and case detection in people aged 16–32 years
in Tanzania, Zimbabwe, and Thailand (NIMH Project Accept, HPTN 043): a randomised
study. The Lancet Infectious Diseases. 11(7):525-32.
[9] Medley AM,
Hrapcak S, Golin RA, Dziuban EJ, Watts H, Siberry GK, et al. (2018). Strategies
for Identifying and Linking HIV-Infected Infants, Children, and Adolescents to HIV
Treatment Services in Resource Limited Settings. JAIDS Journal of Acquired Immune
Deficiency Syndromes. 78: S98-S106.
[10] Govindasamy
D, Meghij J, Negussi EK, Baggaley RC, Ford N, Kranzer K. (2014). Interventions to
improve or facilitate linkage to or retention in pre-ART (HIV) care and initiation
of ART in low- and middle-income settings – a systematic review. Journal of the
International AIDS Society. 17(1):19032.
[11] Yeganeh
N, Simon M, Mindry D, et al. (2017). Barriers and facilitators for men to attend
prenatal care and obtain HIV voluntary counseling and testing in Brazil. PLoS
One. 12(4): e0175505.
[12] Saldana,
J. (2012). The coding manual for qualitative research, 2nd edition. Thousand
oaks, CA: SAGE.
[13] Lincoln
YS, Guba EG. (1985). Naturalistic inquiry. Beverly Hills: Sage.
[14] Guba, E.,
Lincoln, Y. (1989). Fourth generation evaluation. Newbury Park, CA:Sage.
[15] Brewer K.
R. W., Hanif M. (1983). Sampling with unequal probabilities. Spring-verlag, New-York.
[16] Gari S, Martin-Hilber A, Malungo JR, Musheke M, Merten S. (2014).
Sex differentials in the uptake of antiretroviral treatment in Zambia. AIDS Care;26(10):1258-62.
doi: 10.1080/09540121.2014.897911. PMID: 24666201.
[17]
Gonzalez, Monica M. (2016). The coding manual
for qualitative research: a review. The Qualitative Report, vol. 21, no. 8, (pp.
1546+). Link.gale.com/apps/doc/A463514474/AONE?u=anon~a46004e3&sid=googleScholar&xid=0220d70d. Accessed 26 Aug.
2020.
[18] Berge Y. G., & Tille Y. (2009). Sampling with Unequal
Probabilities. Handbook of Statistics 29, part a, 39-54.
[19]
Hanif,
M., & Brewer, K. R. W. (1980). Sampling with Unequal Probabilities without Replacement:
A Review. International Statistical Review / Revue Internationale de Statistique,
48(3), 317–335. https://doi.org/10.2307/1402944.
[20]
Beuving,
J., & de Vries, G. (2015). On naturalistic inquiry: Key issues and practices.
In Doing Qualitative Research: The Craft of Naturalistic Inquiry (pp. 27–46). Amsterdam
University Press. https://doi.org/10.2307/j.ctt130h8g7.7.
[21]
Beuving,
J., & de Vries, G. (2015). Looking at society: Observing, participating, interpreting.
In Doing Qualitative Research: The Craft of Naturalistic Inquiry (pp. 65–88). Amsterdam
University Press. https://doi.org/10.2307/j.ctt130h8g7.9.
[22] Ammon N, Mason S, Corkery JM. (2018). Factors impacting
antiretroviral therapy adherence among human immunodeficiency virus-positive adolescents
in sub-Saharan Africa: a systematic review. Public Health.; 157:20– 31.