: In the context of an implementation research project, aiming at better aligning targeted services with the general health services, we conducted cross-sectional surveys among a representative sample of female sex workers (FSWs) in four cities. We explored, through structured face-to-face interviews, where FSWs procure commodities and services for sexual and reproductive health. We compared service utilization across the four cities and assessed if it was significantly different.
Abstract: Twenty years ago, in 1997, I wrote the following piece reflecting on the Mothusimpilo project, an early attempt to understand and help to manage the epidemic of HIV in South Africa. I thought it might be interesting for you to look back on where we have come from.
Two months ago Lander Willem and I organized the first edition of the short course “Individual-based modelling in epidemiology: A practical introduction”. The feedback at the end of the course was overwhelmingly positive, which left us feeling empowered and encouraged to not leave it at this first edition. Participants of the next edition should expect an even more hands-on course, with more time to acquire skills in developing, exploring and fitting individual-based models.
This study clearly shows the diversity of sex workers (SWs) and their varying HIV treatment needs in the workplace and at home. Standard treatment guidelines could therefore fall short of their intention to reduce vulnerability to poor health outcomes if a non-differentiated approach to care is followed. Trained staff who are sensitised to the local medical, emotional and legal needs of SWs are able to create user friendly services that encourage these vulnerable women to utilise services.
Interventions to curb age-disparate relationships (ADR) are ongoing in spite of conflicting evidence that ADR are a risk factor for HIV transmission. There is a real need to explore the prevalence of ADR and understand what they mean for HIV transmission. We must first understand and describe these relationships; second, establish a causal relationship with HIV. We recently published a paper that explores those objectives in a population of 1,922 adult men and women living in Likoma Island, Malawi.
Early initiation of antiretroviral therapy (ART) significantly improves the survival of people living with HIV (PLWH) and reduces HIV transmission to uninfected partners. Mathematical models suggest that treatment-as-prevention programmes could lead to HIV elimination. How the clinical efficacy of ART in preventing HIV transmission translates to real-life settings depends in large part on the capacity of HIV programmes to engage and retain PLWH. The effects of ART on HIV incidence may also depend on changes in sexual network dynamics during the course of ART scale-up which are discussed in this article.
Despite the importance of youth sexual behaviour for sexual and reproductive health and the severity of the HIV/AIDS there is relatively little empirical research on factors affecting the age at sexual debut in South Africa. In my dissertation I used survival analysis techniques to identify significant predictors of early sexual debut in a South African context. The results may assist in devising strategies and action plans to be used to educate adolescents in making informed and safe decisions regarding sexual debut.
We conducted surveys of travellers and their movement patterns in Mali, Burkina Faso, Zambia and Tanzania. We found that women travelling with children are a consistent group of relevance to malaria transmission. Our study also highlighted youth workers as a key traveller group of relevance to parasite dispersal in Mali.
The objective of my thesis was to develop a novel, parameterised mechanistic mathematical model which describes the dynamics of parasite invasion during the initial stages of malarial infection.
Common indicators such as the number of new sexual partners in a given year and the lifetime number of sexual partners are used in several analyses to predict the risk of contracting HIV. However, are these indicators consistent?