Increased Stigma, and Physical and Sexual Violence Against Men Who Have Sex with Men and Transgender Women in Sub-Saharan Africa: A Qualitative Evidence Synthesis Analyzing Social and Structural Barriers to HIV Testing and Coping Behaviors.

In sub-Saharan Africa, accessing HIV testing services is a significant challenge for men who have sex with men (MSM) and transgender women (TGW). In this qualitative evidence synthesis, our aim is to understand social and structural barriers and how they hinder MSM's and TGW's access to HIV testing services in sub-Saharan African countries. We searched four selective databases (PubMed, Web of Science and CINAHL complemented with Google Scholar) for qualitative studies, published in English between January 2005 and December 2023, generated 1507 articles, of which 22 were included. Thematic synthesis was conducted for data synthesis. This led to five barriers that hinder HIV test uptake among MSM and TGW, which included: non-availability of tailored HIV testing services, stigma, lack of trust among service providers, sexual and physical violence, and criminalization of same sex relationship. To navigate these social and structural barriers and cope with fears of discrimination and criminalization, MSM and TGW engaged into riskier behaviors, including avoiding HIV testing, non-disclosure, or relying on informal or alternative sources of HIV testing. Decriminalization of same-sex relationship and peer-led HIV testing services were noted to address structural barriers, including stigma and poor access, and subsequently increase the participation in HIV testing services.

Sex trafficking, prostitution, and increased HIV risk among women during and after the 2015 Nepal earthquake.

Women might be at increased risk of HIV infection after a disaster situation due to several interlinked environmental and social factors, such as increased sex trafficking and prostitution, in resource-limited settings. However, this information has not been clearly understood. Based on the review of available gray and peer-reviewed evidence, the present debate paper summarizes potential factors for increasing women's HIV risk during/after two earthquakes that hit Nepal in 2015. Poverty and socio-economic crisis, displacement and reduced social capital, increased rate of sex trafficking and prostitution, and poor access to health care seem to be the factors to increase women's HIV risk in the earthquake-affected areas of Nepal. There is a lack of essential empirical evidence on environmental and social factors (e.g. increased sex trafficking and prostitution) that are linked with women's HIV risk in the post-disaster phase. Therefore, the factors and interactions discussed should be further studied potentially in disaster-affected areas so that locally and culturally salient and sustainable relief and reconstruction strategies, which include strategies for preventing HIV risk in post-disaster situations, can be developed.

Social network resources and self-rated health in a deprived Danish neighborhood.

Research has demonstrated that living in a deprived neighborhood contributes to the occurrence and development of poor health. Furthermore evidence shows that social networks are fundamental resources in preventing poor mental health. Neighborhood relationships and networks are vital for sustaining and improving quality of life. However, to determine potentials for public health action, the health impact of various types of network resources need to be explored and the association between socioeconomic position and self-rated health needs to be analysed to determine whether it is partially explained by social network resources. This is the main aim of this article. Cross-sectional data from one deprived neighborhood located in Denmark were collected in 2008 and 2013 using a postal health survey. The target group was defined as adults older than 16 years. In 2008, 408 residents participated in the survey, and 405 residents participated in 2013. Our main explanatory variables were indicators of socioeconomic positions and social network resources. The analyses were conducted using univariate and bivariate analyses and multiple logistic regressions. The results showed that there was a significant decrease in respondents being involuntarily alone during the period from 2008 to 2013. An impact of the association between disposable income and self-rated health was found, showing that low income residents with a better social network also have slightly higher odds of having good self-rated health compared with residents with higher income. This investigation is the first Danish study that repeats a health survey in the same neighborhood to measure possible improvement in health among residents. More longitudinal research is needed in the future to explore the complex relationship between social network resources, social capital and health in neighborhoods.

Factors affecting IUCD discontinuation in Nepal: a nested case-control study.

Information related to contraception discontinuation, especially in the context of Nepal is very limited. A nested case-control study was carried out to determine the factors affecting discontinuation of intrauterine contraceptive devices (IUCDs). A total of 115 cases (IUCD discontinuers) and 115 controls (IUCD continuers) were randomly selected based on the data obtained from the user's record of a family planning center in Kathmandu. Matching criteria were age during insertion and date of insertion of IUCD. Logistic regression was used to analyze the data. When cases were compared with controls, the results showed that place of residence, sex of last child, reproductive intention, experience of side effects, and follow-up practice were associated with discontinuation of the IUCD. Experience of side effects has been seen as the major reason for discontinuation. The results suggest that side effects after IUCD insertion should be properly discussed and promptly treated to reduce the discontinuation rate.

Determinants of pelvic organ prolapse among the women of the western part of Nepal: a case-control study.

AIM: This study was carried out in order to identify the determinants of pelvic organ prolapse (POP) among the women of the western part of Nepal. METHODS: This was a matched case-control study. Cases were defined as women diagnosed with third and fourth degree POP, and the control group consisted of women who were screened and confirmed of not having any degree of POP. Cases (n = 183) and controls (n = 183) were randomly selected and for each case, one control was selected, matched by age and place of residence. A semistructured interview was carried out to obtain the information for both groups. Bivariate analysis along with conditional logistic regression analysis was carried out to identify the association between selected variables with POP. RESULTS: The results showed the significant association between number of vaginal deliveries, tear of vagina in the last childbirth, sphincter damage in the last childbirth and duration of labor in the last childbirth with POP, after adjusting for educational status of the women, carrying heavy loads, type of usual work and incidence of diarrhea. CONCLUSION: The results suggest that prolonged labor along with vaginal delivery having sphincter and vaginal tear are the determinants of POP and program managers should strongly consider these factors to develop interventions targeting the prevention of POP.