Browsing by Author "Livia Montana"

Now showing 1 - 3 of 3
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    Cohort Profile: Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI).
    (2018) F Xavier Go´ mez-Olive´; Livia Montana; Ryan G Wagner; Chodziwadziwa W Kabudula; Julia K Rohr; Kathleen Kahn; Till Ba¨rnighausen; Mark Collinson; David Canning; Thomas Gaziano; Joshua A Salomon; Collin F Payne; Alisha Wad; Stephen M Tollman; Lisa Berkman
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    Reaching for the 'first 95': a cross-country analysis of HIV self-testing in nine countries in sub-Saharan Africa
    (2022-02) Eva van Empel; Rebecca A De Vlieg; Guy Harling; Maja E Marcus; Kathleen Kahn; Till W Bärnighausen; Livia Montana; Augustine T Choko; Jennifer Manne-Goehler
    Objectives: HIV self-testing (HIVST) offers a promising approach to increase HIV diagnosis and advance progress towards the UNAIDS 95-95-95 targets. We aimed to understand patterns of HIVST awareness and utilization in nine sub-Saharan African (SSA) countries, with the goal of identifying populations to target in disseminating this technology. Design: A cross-sectional study. Methods: We pooled individual-level population-based data from nine Demographic and Health Surveys (DHS) in SSA conducted 2015-2019 (Burundi, Cameroon, Guinea, Malawi, Senegal, Sierra Leone, South Africa, Zambia, Zimbabwe). Primary outcomes were HIVST awareness and utilization. We used logistic regression with survey fixed effects to explore the relationship between sociodemographic characteristics and these outcomes. Models were adjusted for sex, age, rural/urban residence, education, wealth, and marital status. We accounted for complex survey design. Results: The study sample included 177 572 people (66.0% women, mean age 29 ± 10 years), of whom 86.6% [95% confidence interval (95% CI) 86.4-86.7] were unaware of HIVST, 11.7% (95% CI 11.6-11.9) were aware of but never used HIVST, and 1.7% (95% CI 1.6-1.8) had used HIVST. In adjusted models, women were less likely to be aware of HIVST [odds ratio (OR) 0.75, 95% CI 0.71-0.79], but more likely to have used HIVST (OR 1.17, 95% CI 1.03-1.32) compared with men. Rural residents, those who were least educated, and poorest were less likely to have heard of or used HIVST. Conclusion: HIVST awareness and uptake were low. Rural, less educated, and lower income populations were least likely to have heard of or used HIVST. Efforts to scale-up HIVST in these settings should aim to reach these less advantaged groups.
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    The Association Between HIV‑Related Stigma and the Uptake of HIV Testing and ART Among Older Adults in Rural South Africa: Findings from the HAALSI Cohort Study
    (2023-11-07) Nomsa B. Mahlalela; Jennifer Manne‑Goehle; Daniel Ohene‑Kwofe; Leslie B. Adams; Livia Montana; Kathleen Kahn; Julia K. Rohr; Till Bärnighausen; Francesc X. Gómez‑Olivé
    HIV testing and antiretroviral therapy (ART) remain critical for curbing the spread of HIV/AIDS, but stigma can impede access to these services. Using data from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), we used a multivariable logistic regression to examine the correlation between HIV-related stigma, HIV testing and ART uptake in older adults. We used four questions to measure stigma, with three assessing social stigma (refecting social distancing preferences) and one assessing anticipated stigma (disclosure concern). We combined the three social stigma questions to generate a social stigma score ranging from 0 to 3, with higher scores indicating higher stigma. Anticipated stigma was prevalent 85% (95% CI 0.84–0.86), and social stigma was also frequent 25% (95% CI 0.24– 0.27). Higher social stigma scores correlated with decreased HIV testing for all participants with social stigma. Compared to those with a score of 0, odds of testing decreased with higher stigma scores (OR=0.66, 95% CI 0.53–0.81, p=0.000) for a score of 1 and (OR=0.56, 95% CI 0.38–0.83, p=0.004) for a score of 3. ART uptake also decreased with higher social stigma scores among people living with HIV (PLWH), although it was significant for those with a score of 2 (OR =0.41, 95% CI 0.19–0.87, p=0.020). These findings emphasize that HIV-related stigma hampers testing and ART uptake among older adults in rural South Africa. Addressing stigma is crucial for improving testing rates, early diagnosis, and treatment initiation among the older population and achieving UNAIDS 95–95–95 targets.