HIV and AIDS: prevention, care, ARV adherence Research Papers (original) (raw)

Information and communication technology (ICT) is transforming community-based and community-led HIV prevention and care services for gay men, other men who have sex with men (MSM) and transgender people. This book celebrates and shares... more

Information and communication technology (ICT) is transforming
community-based and community-led HIV prevention and care services for gay men, other men who have sex with men (MSM) and transgender people. This book celebrates and shares crucial work of frontline HIV workers, activists, researchers and educators whom are using innovative ICT.

- by and +1
- •
- Digital Technology, Mobile Technology, HIV and AIDS education, HIV/AIDS
- by Maureen Hennessey
- •
- Social Networks, Social Networking, Coaching Psychology, Medication Adherence
- by Louise Rasmussen
- •
- Religion, African Studies, Development Studies, Ethnography

With the lack of attention to the attrition of child participants, loss to follow up (LTFU) holds significant implications for the health of young adults in the Pediatric HIV/AIDS Cohort Study (PHACS), a multi-center cohort study with children either perinatally infected with HIV (PHIV) or HIV-exposed uninfected (HEU). Young adults (18+) face barriers to being retained in the study, including competing time demands, geographic relocation, study fatigue, stigma, and low health literacy. Formative research, Photovoice (participatory photo elicitation), and a focus group informed the design of a web-based media strategy based on the Elaboration Likelihood Model (ELM) to increase study engagement. Six members of the Young Adult and Adult Community Advisory Boards (CABs) were recruited via email and given Photovoice training via Prezi. Photos were taken around the theme of self-identity. A teleconference focus group facilitated reflections and salient themes for the video compilation exhibit. Themes included: 1) stereotypes, 2) layered-identities, 3) stigma, and 4) self-identity. Additional meta-themes were also codified. Media strategy recommendations included: 1) participatory media and photography, 2) digital story maps, 3) social media, and 4) content and topics. Based on the results of this project with a limited sample, participatory media like Photovoice may have a positive impact on participants at risk for LTFU by increasing study engagement. While some research supports this qualitative methodology, limitations must be considered. Future PHACS projects should incorporate a needs assessment and evaluation. Moreover, further research in this area of public health and health communication needs to continue overall.

- by Alexandra Dima and +1
- •
- Medication Adherence, HIV and AIDS: prevention, care, ARV adherence

Since Grassroot Soccer’s founding in 2002, research has been vital to its organisational growth and development. Research and innovation shape the organisatoin's curriculum development, monitoring and evaluation processes, and strategy. This report examines Grassroot Soccer's sport and sexuality education programmes for adolescent girls in South Africa, also expanded throughout sub-Saharan Africa, with broader literature complemented by unique insights and recommendations from its work. Grassroot Soccer learns by evaluating its work scientifically, and the organisation has seen that the process of engaging adolescent girls in a well-designed, sport-based, inclusive sexual and reproductive health and rights (SRHR) programme can be gender transformative, and results in a range of positive outcomes for girls and their broader communities. Grassroot Soccer has also learned that young people want to learn about sexuality more broadly, as opposed to separating issues such as HIV, gender, relationships, power, violence, safety, sexuality and identity. The organisation recognises that young people are too diverse an audience to group together meaningfully in sexuality education. Grassroot Soccer is thus striving to understand the ways in which sex, age, gender and socialisation shape what is appropriate messaging for adolescents, and understands the need to involve youth in these processes and work with adolescents and peer educators to design interventions that relate to their identities and experiences. This report draws on recent Grassroot Soccer research projects in South Africa to illustrate sport’s potential as a communication platform in sexuality education, in particular for adolescent girls. Five broad themes emerged from these projects that highlight the unique contributions that well-designed Sport for Development initiatives can make to improve sexuality education and SRHR outcomes: (1) Sport is engaging, (2) Sport is physical, (3) Sport is gendered, (4) Sport is empowering and (5) Sport is about relationships. This resource is intended for communities, development practitioners, research institutions, governments and donor agencies, with the hope that the insights herein will help to guide the design of future interventions and research on the use of sport in sexuality education.

- by Jenn Warren and +2
- •
- Participatory Design, Research Methods in Physical Education and Sport, Southern Africa, Sport for Development
- by Mary Step
- •
- Communication, Health Communication, Cancer, Social Media
- by Dorra Ben Alaya
- •
- HIV and AIDS education, HIV/AIDS, Attitudes (Social Psychology), HIV

Resumen El VIH/SIDA es una patología de alto costo que implica como mínimo un 95 % de adherencia al tratamiento antirretroviral para garantizar el control viral y el mejoramiento de la calidad de vida de los pacientes (Hernández, A. et al. 2013; Peñarrieta et al. 2009; Remor, 2002; Tafur, Ortiz, Alfaro, García & Faus, 2008). Este estudio teórico clásico tuvo por objetivo revisar el estado del arte sobre la adherencia al tratamiento antirretroviral en pacientes VIH y la implementación de la terapia de aceptación y compromiso (ACT) para mejorarla. Se consultaron sesenta estudios en diferentes bases de datos que abordan la adherencia al tratamiento antirretroviral, factores que influyen, intervenciones para potenciarla y aproximaciones dadas desde la ACT para abordar el problema de la adherencia, el estigma y otras problemáticas con intervención grupal e individual. Se concluye que la investigación aplicando la ACT para promover la adherencia al tratamiento antirretroviral es escasa, y se necesitan más estudios en el tema. Palabras clave: VIH/SIDA, adherencia, intervención, terapia de aceptación y compromiso. Abstract HIV / AIDS is a high-cost pathology involving at least 95 % adherence to antiretroviral therapy to ensure viral control and improve the quality of life of patients (Hernández et al.

Research has shown that African-born immigrants to the U.S. have a high risk of HIV infection, and more than half of them reside in one of seven states with Massachusetts being home to more than 66,000 residents. As of 2009, the largest proportion of non-U.S. born persons in MA diagnosed with HIV infection was from Sub-Saharan Africa. Because only a few studies have focused on HIV-testing attitudes and stigma in this population, very little is known about how to provide culturally appropriate HIV prevention and screening activities, particularly among African-born men. Not only to they have a high rate of HIV seropositivity and present at a late stage of HIV disease, but they also experience significant HIV-related stigma. Moreover, barriers and misconceptions about the U.S. healthcare system and legal and linguistic challenges persist. Thus, the need to provide interventions to reduce barriers to HIV testing, decrease stigma, and increase access to healthcare services in this community emerged.

The discrimination in HIV / AIDS has been taken into considerations of the cases of health, economic, social, cultural, religious, and political or policy decision making and law or legal implications and implementation that needed to overcome in real holistically actions by escalating the prevention and treatment actions of the case of the discrimination in HIV / AIDS. To reaching this holistically actions of prevention, Indonesia and the other fifteen Countries namely; Bangladesh, Cambodia, Cameroon, Kenya, Kyrgyzstan, Malawi, Nepal, Pakistan, Rwanda, South Africa, Tajikistan, Tanzania, Ukraine, Uzbekistan, and Vietnam where have been cooperated into an International Bilateral Relationship with Germany’s global health Strategic within priorities on health systems strengthening of HIV/AIDS prevention and treatment. The case of discrimination in HIV / AIDS in Indonesia became un expected polemic and case for measuring the level of health quality of human and the efforts of all stakeholders to control HIV / AIDS by strengthening the holistically actions among national and international corporations.
Germany is known as the second largest country in Europe who engages in global health protection over the past decade. Germany has financially contributed to global health from 544.4millionin2005to544.4 million in 2005 to 544.4millionin2005to977.5 million in 2010. From this Bilateral assistance of Germany to Indonesia and the other fifteen countries to accelerate the case of sustaining global health including prevention HIV / AIDS where Germany’s assistance accounted around 49 % ($475.3 million) of the health expenditure. Whilst, of 51% ($502.2 million) was assisted the multilateral organizations. Germany supports actively the acceleration of preventing the HIV AIDS for Indonesia through this kind of bilateral corporation.

- by Sherly Diana da Costa
- •
- Human Rights, HIV and AIDS education, HIV/AIDS, HIV

The purpose of this workshop is to introduce the use of public radio as an enlightenment tool for HIV-AIDS across the population. Participants would be trained on the process/procedures of utilizing the radio to run literacy programmes on HIV-AIDS. This radio project is an innovative community sensitization programme planned for public listeners but specifically targeting people living with HIV-AIDS and their families. This is a mobile learning activity that would provide training to participants on how to develop/utilize public radio to facilitate HIV-AIDS literacy and mass enlightenment on HIV-AIDS. By HIV-AIDS literacy, we mean empowering an individual or people living with the HIV-AIDS to have the ability to read, write and understand the issues surrounding HIV-AIDS – coping with HIV-AIDS, medication, work and stay alive! Furthermore, people in the society are taught about HIV-AIDS – its causes, prevention, cure, and supporting people living with HIV-AIDS through the Radio HIV-AIDS Literacy project. The participants will learn the strategies to plan, package and execute the community radio talkshow to reach-out to their respective communities – using phone-in live discussions, guest interviews, music, debates, quizzes, dramas, role plays, etc, to educate and enlighten the listener on HIV-AIDS.

- by IBRAHIM WADEMBERE
- •
- Social Change, Health Promotion, Epidemiology, Social epidemiology

The AIDS epidemic has resulted in mental illnesses associated with mourning and unresolved grief. Traditional mourning rituals in rural and urban Africa have been altered and in some cases abandoned in the face of huge loss. The Museum of AIDS in Africa identified a need to support individuals through the grief process by combining traditional mourning rituals with new approaches within common contexts of loss from HIV/AIDS, creating and curating a collective group narrative to empower participants. The Museum hypothesized that objects could play an important role in supporting the grief process. The project forms part of the Museum's commitment to preserve, educate, promote dialogue and memorialize the history of AIDS in Africa.

- by Carol Devine
- •
- Cultural History, Museum Studies, Mental Health, Narrative Therapy

Uganda’s ABC approach to the prevention and control of HIV/AIDS has gained prominence and
garnered controversy in recent years. Several studies have praised the approach for its remarkable feat
in reducing HIV prevalence rates, while others, especially recently, have started to criticise and
question this alleged success. Studies from the Ministry of Health’s sero-behavioural survey (2005)
and UNAIDS’Aids Epidemic update (2005) have reported that despite years of dramatic success,
Uganda stands at the brink of reversed HIV/AIDS success with prevalence rates stagnating between
6-7% of the total population for the last five years. Although several researchers and development
agencies have tried to study this stagnation problem, the majority of their writing centres on issues
like; government of Uganda bias in favour of ‘AB’ of the ‘ABC,’ the U.S Government’s Emergence
Plan for Aids Relief, which critics say, emphasises certain aspects of the campaign and downplays
others, and “complacency and aids fatigue” among members of the target audiences.
While this study does not explore all the above propositions, it adds to this debate and attempts to
explain the above stagnation problem from a communications angle; looking specifically at the
efficacy of ABC messages in relation to their design, reception and impact. Who designs ABC
messages and how are they designed? How relevant are the designed messages to members of the
target audiences? How do audience members receive and react to these messages and what impact, if
any, do these messages have on their target populations? The academic impetus driving this study
emanates from Prochaska et al’s (1992) Stages of Change model and Bandura’s (1986) Social
Cognitive Theory, both of which are part and parcel of the wider health communications and
behaviour change communications.
From in-depth qualitative interviews with ABC message designers and a largely open-ended
questionnaire with the different ABC audiences, the study reports that the current stagnation in
Uganda’s HIV reduction efforts is partly, communication related. The manner in which ABC
messages are designed is not entirely reflective of the audiences’ dynamic and complex socio-cultural
environment. Specifically, the MoH’s HEPU and ACP and the UAC have not fine-tuned the ABC
model to suit the dynamic and challenging circumstances of intended receivers. The majority of
messages like; Be Responsible, Say No to Un-safe Sex…Use a Condom are too general and do not
address the current “stages of change” to which audience members lie on the behaviour change
continuum.
The study recommends that while the ABC model has had tremendous success over the years, it needs
to be fine-tuned and energized to suit new trends and circumstances of the target audiences. It needs to
go beyond raising awareness and include what Bandura (1986) calls “self-efficacy factors,” which are;
skills building, motivation, modelling, social support enhancement and confidence building. The
design of ABC messages should also be targeted, tailored and customised to suit the needs and
circumstances of various audiences at their respective stages of change.

- by Barbra Natifu and +1
- •
- Health Communication, HIV and AIDS education, HIV/AIDS, Communication for Development

The Centers for Disease Control and Prevention (CDC) has announced a set of provisional guidelines concerning male circumcision, in which they suggest that the benefits of the surgery outweigh the risks. In this brief comment, I highlight... more

- by Brian D . Earp
- •
- Sociology, Criminal Law, Constitutional Law, Health Sciences

The non-therapeutic alteration of children’s genitals is typically discussed in two separate ethical discourses: one for girls, in which such alteration is conventionally referred to as “female genital mutilation” (or FGM), and one for boys, in which it is conventionally referred to as “male circumcision.” The former is typically regarded as objectionable or even barbaric; the latter, benign or beneficial. In this paper, however, I call into ques- tion the moral and empirical basis for such a distinction, and I argue that it is untenable. As an alternative, I propose an ethical framework for evaluating such alterations that is based upon considerations of bodily autonomy and informed consent, rather than sex or gender.

- by Brian D . Earp
- •
- Religion, Comparative Religion, History, Cultural History

HIV, AIDS and Islam (SWAHILI)

Faktor penyebab tertularnya penyakit hiv aids

- by Lutfi Koto
- •
- HIV and AIDS education, HIV/AIDS, HIV/AIDS policy, HIV

A presente pesquisa tem como principal objetivo investigar as características do casal heterossexual moderno praticante de swing. Em especial, busca-se compreender quais fatores influenciam as negociações dos adeptos acerca da prevenção de DSTs/Aids. O swing, também conhecido como troca de casais, é considerado uma das experiências possíveis de não
exclusividade sexual dentro da relação conjugal, o que significa dizer que os parceiros que o praticam, em comum acordo, permitem a ocorrência de intercursos sexuais envolvendo
terceiros e preferencialmente em ambientes compartilhados. O estabelecimento do swing enquanto estilo de vida é a principal premissa dos praticantes. A partir das observações
etnográficas de festas swingers realizadas em uma boate na Zona Oeste da cidade do Rio de Janeiro, da análise dos discursos de casais informantes e do levantamento das pesquisas sobre swing realizadas no Brasil, Europa e Estados Unidos, foi possível refletir a respeito das particularidades socioculturais deste grupo, bem como apreender o conjunto de valores que o orientam. As trajetórias dos sujeitos, desde o descobrimento do swing até o envolvimento real com o universo em questão, também são abordados neste trabalho. Finalmente, procura-se descrever e analisar os principais aspectos em torno das condutas sexuais dos swingers – e a
relação destas com o uso ou desuso de estratégias preventivas – a fim de suscitar reflexões contributivas às discussões sobre prevenção de DSTs/Aids entre swingers.

This document covers the most current scientific understandings of the factors that affect biological risk
of HIV infection and transmission. There have been significant scientific advancements in understanding the biomedical aspects of HIV risk and prevention since the publication, HIV Transmission: Guidelines for Assessing Risk (Transmission Guidelines) was last updated in 2005. This document primarily focuses on the risk of transmission through sexual contact. It summarizes the scientific evidence about the biomedical aspects of risk and transmission, without commenting on social or behavioural factors which are equally important but are beyond the scope of this document.

- by San Patten
- •
- HIV/AIDS, HIV and AIDS: prevention, care, ARV adherence
- by Gabriel Anabwani and +5
- •
- Sexuality, HIV/AIDS, Gender and Sexuality, Gender
- by Carlos F. Caceres and +1
- •
- Human Rights, HIV/AIDS, Gender and Sexuality, History of Sexuality
- by Judy Bradford and +1
- •
- Sexual Violence, HIV/AIDS, Transgender Health, Employment Discrimination

Around the world, HIV prevalence rates for commercial sex workers (CSW), people who inject drugs (PWID), and men who have sex with men (MSM) outpace prevalence rates for the population as a whole. In addition, people in these three groups often face social stigma, punitive legal systems, and judgment from care providers that create barriers to effective prevention, treatment, and support programs to address their particular needs and priorities. Globally, the HIV prevalence data for these key populations are glaringly incomplete and further research into the epidemiological profiles for all three groups is urgently needed. While targeted prevention initiatives for CSW, PWID, and MSM have been developed, they do not reach most members of these communities. The legal and policy environment in many countries exacerbates these issues because members of key populations are often subject to criminal prosecution for the behaviors that put them at risk for HIV. Despite these challenges, comprehensive services for key populations are a priority for the President’s Emergency Plan for AIDS Relief (PEPFAR).
Religion has a complex effect for people in key populations in relation to HIV risk or HIV services. On the one hand, it contributes to stigma and judgment that contribute to risky behaviors and create barriers to care; on the other, it has been a strong motivating factor for compassionate programs and courageous advocacy. Religions can offer theological perspectives that support effective HIV prevention, treatment, and support services. These perspectives may be developed not only by religious leaders but by people of faith working at the grassroots level. There are a number of effective faith-based programs that provide essential services to members of key populations. These programs offer a set of best practices for faith-based work with key populations.

Research Team: Babatunde Ahonsi (Nigeria) Nahla Tawab (Egypt) Scott Geibel and Sam Kalibala (Kenya) Jerry Okal (Uganda) Babacar Mane (Senegal) Nathi Sohaba and Julialynne Walker (South Africa) Eric Green (United States).
This study, implemented between August 2011 and July 2012, sought to provide a comprehensive, evidence-based picture of the HIV-related issues facing young people across Africa, and the prevailing legal, policy, and programmatic responses. The study was designed to establish a basis for a sharper focus on youth within the response to HIV on the continent. Our researchers conducted country-specific analytical reviews of the relevant literature on factors associated with HIV risk-taking and health-seeking behaviors among young people aged 15–24 in six countries across Africa—Egypt, Kenya, Nigeria, Senegal, South Africa, and Uganda. In addition, qualitative and quantitative analyses enabled an evaluation of the similarities and differences among countries regarding factors associated with young people’s sexual risk behavior, HIV-related health-seeking behavior, and the extent of policy and programmatic involvement.

In spite of several attempts over many years at developing a HIV vaccine based on classical strategies, none has convincingly succeeded to date. As HIV is transmitted primarily by the mucosal route, particularly through sexual intercourse, understanding antiviral immunity at mucosal sites is of major importance. An ideal vaccine should elicit HIV-specific antibodies and mucosal CD8+ cytotoxic T-lymphocyte (CTL) as a first line of defense at a very early stage of HIV infection, before the virus can disseminate into the secondary lymphoid organs in mucosal and systemic tissues. A primary focus of HIV preventive vaccine research is therefore the induction of protective immune responses in these crucial early stages of HIV infection. Numerous approaches are being studied in the field, including building upon the recent RV144 clinical trial. In this article, we will review current strategies and briefly discuss the use of adjuvants in designing HIV vaccines that induce mucosal immune responses.

Few evidence-based interventions to improve adherence to antiretroviral therapy have been adapted for use in Africa. We selected, culturally adapted and tested the feasibility of a cognitive-behavioural intervention for adherence and for delivery in a clinic setting in Harare, Zimbabwe. The intervention consisted of a single, 50-minute problem-solving cognitive-behavioural intervention session with four skill-based booster sessions, delivered by four lay adherence counsellors in the context of HIV care. Adaptation followed a theoretically driven approach to intervention adaptation, Assessment-Decision-Administration-Production-Topical Experts-Integration-Training-Testing (ADAPT-ITT), and included modifications to language, session length, tailoring content for delivery by lay counsellors and inclusion of culturally competent probes. The feasibility of the intervention was evaluated using a mixed-methods assessment, including ratings of provider fidelity of intervention delivery, and qualitative assessments of feasibility using individual semi-structured interviews with counsellors (n = 4) and patients (n = 15). The intervention was feasible and acceptable when administered to 42 patients and resulted in improved self-reported adherence in a subset of 15 patients who were followed up after 6 months. Next steps from this study include conducting a randomised control trial to evaluate the adapted intervention compared to standard of care in a larger sample over a long-term follow-up.

- by Melanie A Abas and +1
- •
- Depression, HIV/AIDS, Global Health, HIV and AIDS: prevention, care, ARV adherence

On the basis of three seriously flawed sub-Saharan African randomized clinical trials into female-to-male (FTM) sexual transmission of HIV, in 2007 WHO/UNAIDS recommended circumcision (MC) of millions of African men as an HIV preventive measure, despite the trials being compromised by
irrational motivated reasoning, inadequate equipoise, selection bias, inadequate blinding, problematic randomization, trials stopped early with exaggerated treatment effects, and failure to investigate non-sexual transmission. Several questions
remain unanswered. Why were the trials carried out in countries where more intact men were HIV+ than in those where more circumcised men were HIV+? Why were men sampled from specific ethnic subgroups? Why were so many men lost to follow-up? Why did men in the intervention group receive additional counselling on safe sex practices? The absolute reduction in HIV transmission associated with MC was only 1.3 % (without even adjusting for known sources of error
bias). Relative reduction was reported as 60 %, but after correction for lead-time bias alone averaged 49 %. In a related Ugandan RCT into male-to-female (MTF) transmission, there was a 61 % relative increase (6 % absolute increase) in HIV
infection among female partners of circumcised men, some of whom were not informed that their male partners were HIV+ (also some of the men were not informed by the researchers that they were HIV+). It appears that the number of circumcisions needed to infect a woman (Number Needed to Harm) was 16.7, with one woman becoming infected for every 17 circumcisions performed. As the trial was stopped early for “futility,” the increase in HIV infections was not statistically
significant, although clinically significant. In the Kenyan trial, MC was associated with at least four new incident infections. Since MC diverts resources from known preventive measures and increases risk-taking behaviours, any long-term benefit in reducing HIV transmission remains dubious.

- by Max Carocci
- •
- Native American Studies, Medical Anthropology, Textiles, Material Culture Studies
- by Sujit Kar and +1
- •
- HIV/AIDS, HIV, HIV and AIDS: prevention, care, ARV adherence, HIV and AIDS

Feldblum et al. (2015) argue that voluntary medical male circumcision (VMMC) using the ShangRing device leads to increased sexual pleasure, universally satisfying cosmetic outcome, and virtually no delayed complications in a 2-3 year follow-up study. In this commentary, I suggest that socially desirable responding (SDR) is a likely candidate explanation for at least some of these reported findings, and I argue that this should have been controlled for using available measures. I also highlight evidence from the authors’ own study for risk compensation as a result of circumcision (including decreased condom use and an increase in number of sexual partners) and ask why this adverse outcome was not emphasized as a cause for concern. I conclude by providing 6 concrete suggestions for improving future studies on circumcision.

- by Brian D . Earp
- •
- Religion, Physiology, Human Physiology, Cultural Studies

On the basis of semi-structured interviews conducted in 2010 and 2012, this article examines some of the social and economic impacts of transactional sex within a low-income area of Dar es Salaam, and how opportunities for
transactional sex, in turn, have been expanded by mobile telephony. On the basis of my interviews, I posit that in areas of chronic poverty, familial strategies born of poverty depend on cooperation among family members, and it is therefore important to study those factors which most heavily influence an individual’s willingness to cooperate. I conclude that transactional sex, and the new possibilities afforded by mobile phones for minors to conceal their sexual behavior from caretakers, are key elements in the intergenerational transmission of female poverty through early pregnancy and early marriage.

- by Laura Stark
- •
- African Studies, Anthropology, Social Anthropology, Sex and Gender

The MEEPP design was able to address the reporting needs of PEPFAR, but there
is an emerging concern to address the needs of GOU regarding the HIV/AIDS
M&E.
2. In terms of availability and timeliness of output data, MEEPP was implemented as
designed. However, the customized reports on the MEEPP website are
insufficiently detailed to meet the needs of some stakeholders.
6
3. MEEPP has met the expectations of PEPFAR and the prime partners with regard
to quality of data; however, several challenges, such as double-reporting, continue
to affect data quality.
4. Despite accessibility of the MEEPP website, both in terms of inputting data and
obtaining reports, some users still make special data requests to MEEPP.
5. MEEPP has helped prime partners to strengthen their data systems. However
some primary data sources (i.e., IPs) require support to strengthen their M&E
capacity.
6. MEEPP does not have an explicit mandate to build the M&E capacity of GOU
agencies. However, it is making special efforts to do so on an ad hoc basis.
7. Aspects of MEEPP that may need change include systematic engagement of
public sector stakeholders by promoting and supporting utilization of PEPFAR
data, and increased emphasis on evaluation.

A Manual Workbook Based on Compassion, Responsibility and Justice

- by farid esack
- •
- HIV and AIDS education, HIV/AIDS, Contemporary Movements and Trends in Islam, Islam

Drug use practices that can lead to transmission of HIV, HCV, and other harms are pressing issues affecting communities throughout Canada. Existing best practice recommendations for needle and syringe programs are out of date. To stay current with the best available scientific evidence and ensure that people have access to high-quality services that help prevent drug-related harms, best practices must undergo review and update. We created an updated set of user-friendly recommendations that will benefit harm reduction programs across the country. Our community-based team involved members from across Canada representing people who use drugs, service providers, researchers, and policy makers. We used a consensus process to design the project and make all project decisions. Using a narrative synthesis method, we reviewed and synthesised best-available scientific evidence to create best practice recommendations related to: needle and syringe distribution; other injecting equipment distribution; safer crack cocaine smoking equipment distribution; safer disposal and handling of used drug use equipment; safer drug use education; and use of naloxone in overdose prevention. By using a broad dissemination strategy, we will reach a wide audience who will use the document, including people who use drugs and service providers, at harm reduction programs across Canada.

- by Carol Strike and +1
- •
- Best practices guidelines, Harm Reduction, HIV and AIDS: prevention, care, ARV adherence

Broadening sexual health and HIV care in NHS settings to holistically address the general and sexual wellbeing of gay, bisexual and other men who have sex with men (MSM), via community engagement, arts, theatre, film, spoken work and cultural spaces. Generating cultural dialogue and action around challenging, topical issues to better understand the lifestyle needs that impact the sexual wellbeing of our patients. With the purpose of affecting HIV/STI epidemiology and community/individual wellbeing.

- by David Stuart
- •
- Sex and Gender, Sexuality, HIV and AIDS education, HIV/AIDS