Population and Development Center

To increase HIV status awareness among men who have sex with men (MSM) and female sex workers (FSWs), a community-based HIV testing program was implemented for the first time in Haiti. We aimed to assess 1) the effectiveness of the program to reach HIV-exposed populations over time and 2) the characteristics, HIV exposure, and testing profile of program participants. Rapid diagnostic HIV testing (RDT) was offered to all individuals present in several community-based settings across Haiti. Trends in the number of tested individuals, first-time tested, and HIV positive tested per intervention were described using linear regression. Characteristics and factors related to the first-time test were described. Between July 2015 and April 2018, 445 interventions in 91 community-based venues resulted in 3,998 rapid tests performed. A median of eight individuals was tested per intervention, with 18% first-time testers and 6% with HIV-positive results. The overall numbers of tests and positive test results increased over the intervention program period. Within 1,572 first-time RDT testers (1,216 MSM, 235 FSWs, and 121 nonkey population), 31% (n = 489) were first-time HIV testers. First-time tested individuals reported HIV exposure, such as lack of condom use at last intercourse (33%), transactional sex (35%), and recent (≤12 months) sexually transmitted infection (12%). The community-based HIV testing program effectively reached HIV-positive and previously untested individuals over a 3-year period. Continued community-based testing in conjunction with other HIV testing services is recommended for Haiti.

Self-Help Groups (SHGs), the credit based voluntary groups in India are widely known for their potential to alleviate poverty and empower women. This research article explores a lesser-known theme. It tries to analyze the possibility of utilizing the current SHG model of the Indian Government to build and strengthen resilience of the SHG members in case of an external shock like financial stress, food insecurity, dispute in home for joining SHG, and difficulty to repay loan amidst lockdown due to the COVID-19 pandemic. This article also focuses on their coping mechanisms and attitude towards these crises. By utilizing primary data collected from 320 SHG members in one of the aspirational districts in West Bengal, India, the present paper tries to fulfill its objective. It provides a comprehensive understanding of the problems faced by the SHG members by combining both quantitative and qualitative techniques. The findings reveal that from organizing vocational trainings to relaxing loan repayment, SHGs and its women members overcame various adversities with tenacity, especially during the COVID-19 pandemic. Based on the study findings, it is reasonable to conclude that the current SHG model in India presents a promising avenue for enhancing the resilience of its members in the face of external shocks.

BackgroundCoverage of HIV testing remains sub-optimal in West Africa. Between 2019 and 2022, the ATLAS program distributed ~400 000 oral HIV self-tests (HIVST) in Côte d’Ivoire, Mali, and Senegal, prioritising female sex workers (FSW) and men having sex with men (MSM), and relying on secondary redistribution of HIVST to partners, peers and clients to reach individuals not tested through conventional testing. This study assesses the proportion of first-time testers among HIVST users and the associated factors.MethodsA phone-based survey was implemented among HIVST users recruited using dedicated leaflets inviting them to anonymously call a free phone number. We collected socio-demographics, sexual behaviours, HIV testing history, HIVST use, and satisfaction with HIVST. We reported the proportion of first-time testers and computed associated factors using logistic regression.ResultsBetween March and June 2021, 2 615 participants were recruited for 50 940 distributed HIVST (participation rate: 5.1%). Among participants, 30% received their HIVST kit through secondary distribution (from a friend, sexual partner, family member, or colleague).The proportion who had never tested for HIV before HIVST (first-time testers) was 41%. The main factors associated with being a first-time tester were sex, age group, education level, condom use, and secondary distribution. A higher proportion was observed among those aged 24 years or less (55% vs 32% for 25–34, aOR: 0.37 [95%CI: 0.30–0.44], and 26% for 35 years or more, aOR: 0.28 [0.21–0.37]); those less educated (48% for none/primary education vs 45% for secondary education, aOR: 0.60 [0.47–0.77], and 29% for higher education, aOR: 0.33 [0.25–0.44]). A lower proportion was observed among women (37% vs 43%, aOR: 0.49 [0.40–0.60]); those reporting always using a condom over the last year (36% vs 51% for those reporting never using them, aOR: 2.02 [1.59–2.56]); and those who received their HISVST kit through primary distribution (39% vs 46% for secondary distribution, aOR: 1.32 [1.08–1.60]).ConclusionATLAS HIVST strategy, including secondary distribution, successfully reached a significant proportion of first-time testers. HIVST has the potential to reach underserved populations and contribute to the expansion of HIV testing services in West Africa.

Ce livret est un outil d’aide à la décision qui est utilisé dans un projet de recherche intitulé QUALI-DEC. Ce projet a pour objectif d’améliorer la prise de décision concernant l’accouchement. Ce support est remis par un professionnel de santé aux femmes enceintes pour les aider à choisir le mode d’accouchement le plus approprié pour elle et son bébé.

This database contains the necessary data and scripts to compile results as published in <strong>The Global Human Day (2023), PNAS 120 (25). </strong> For more information on the project, please visit www.humanchronome.org For more information on the group, please visit www.earthsystemdynamics.org

This database contains the necessary data and scripts to compile results as published in <strong>The Global Human Day (2023), PNAS 120 (25). </strong> For more information on the project, please visit www.humanchronome.org For more information on the group, please visit www.earthsystemdynamics.org Version 1.1 change log: - Removed macOSX journaling - Tidied subcategory names in output files

BackgroundTelehealth usage has been promoted in all settings but has been identified as a panacea to issues of access and equity in the rural context. However, uptake and widespread integration of telehealth across all parts of the health system has been slow, with a myriad of barriers documented, including in rural settings. The crisis of the COVID-19 pandemic, saw barriers rapidly overturned with the unprecedented and exponential rise in telehealth usage. The uniqueness of the crisis forced telehealth adoption, but as the urgency stabilises, pandemic learnings must be captured, utilised, and built upon in a post-pandemic world. The aim of this study was to document staff experiences and perceptions of delivering rural psychological therapies via telehealth during the pandemic and to capture learnings for future rural telehealth delivery.MethodsAn online cross-sectional survey that explored mental health professional’s experiences, use, and perceptions of telehealth before and after pandemic-enforced changes to service delivery.ResultsSixty-two respondents completed the questionnaire (response rate 68%). Both the delivery of telehealth via telephone and online video conferencing significantly increased during the pandemic (66% vs 98%, p < .001 for telephone and 10% vs 89%, p < 0.001 for online video). Respondents indicated that client’s access to services and attendance had improved with telehealth use but their attention and focus during sessions and non-verbal communication had been negatively affected. The challenges for older adults, people with learning and sensory disabilities, and residents in remote areas with poorer mobile/internet connectivity were identified. Despite these challenges, none of the respondents indicated a preference to return to fully face-to-face service delivery with most (86%) preferring to deliver psychological therapies fully or mostly via telehealth.ConclusionsThis study addresses three major gaps in knowledge: the experience of delivering local telehealth solutions to address rural mental health needs, the provision of strong rural-specific telehealth recommendations, and the dearth of rural research emanating from the United Kingdom. As the world settles into a living with COVID-19 era, the uniqueness of the rural telehealth context may be forgotten as urban myopia continues to dominate telehealth policy and uptake. It is critical that rural resourcing and digital connectivity are addressed.

The article deals with the relation between higher education and employment in Sudan. It evaluates the efficiency of a training project realized in collaboration between international and local private and government partners that aimed to provide university graduates with employment opportunities. The INSO Project (Innovation in society: training paths and human capital enhancement in Sudan) took place from 2017 to 2019. The research methodology consists of a questionnaire survey among the project participants to collect data on their employment achievements two years after their graduation and a series of interviews about their professional integration. The collected data are analyzed in the context of the Sudanese socio-economic and higher educational context and development. The study reveals a significant rate of employment for the graduates of this training project, its limits and the good use of specific training related to job search techniques.

IntroductionCervical cancer (CC) causes thousands of deaths each year. Nearly 100% of cases are caused by oncogenic strains of human papillomavirus (HPV). In most industrialised countries, CC screening (CCS) is based on the detection of HPV infections. For many reasons including lower adherence to CCS, underserved women are more likely to develop CC, and die from it. We aim to demonstrate that the use of incentives could improve screening rates among this population.Methods and analysisOur cluster randomised, controlled trial will include 10 000 women aged 30–65 years eligible for CCS, living in deprived areas in four French departments, two mainlands and two overseas, and who did not perform physician-based HPV testing within the framework of the nationally organised screening programme. HPV self-sampling kit (HPVss) will be mailed to them. Two interventions are combined in a factorial analysis design ending in four arms: the possibility to receive or not a financial incentive of €20 and to send back the self-sampling by mail or to give it to a health professional, family doctor, gynaecologist, midwife or pharmacist. The main outcome is the proportion of women returning the HPVss, or doing a physician-based HPV or pap-smear test the year after receiving the HPVss. 12-month follow-up data will be collected through the French National Health Insurance database. We expect to increase the return rate of HPV self-samples by at least 10% (from 20% to 30%) compared with the postal return without economic incentive.Ethics and disseminationEthics approval was first obtained on 2 April 2020, then on July 29 2022. The ethics committee classified the study as interventional with low risk, thus no formal consent is required for inclusion. The use of health insurance data was approved by the Commission Nationale Informatique et Libertés on 14 September 2021 (ref No 920276). An independent data security and monitoring committee was established. The main trial results will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT04312178.

When the threat of COVID-19 became widely acknowledged, many hoped that this pandemic would squash "the anti-vaccine movement". However, when vaccines started arriving in rich countries at the end of 2020, it appeared that vaccine hesitancy might be an issue even in the context of this major pandemic. Does it mean that the mobilization of vaccine-critical activists on social media is one of the main causes of this reticence to vaccinate against COVID-19? In this paper, we wish to contribute to current work on vaccine hesitancy during the COVID-19 pandemic by looking at one of the many mechanisms which can cause reticence towards vaccines: the capacity of vaccine-critical activists to influence a wider public on social media. We analyze the evolution of debates over the COVID-19 vaccine on the French Twittosphere, during two first years of the pandemic, with a particular attention to the spreading capacity of vaccine-critical websites. We address two main questions: 1) Did vaccine-critical contents gain ground during this period? 2) Who were the main actors in the diffusion of these contents? While debates over vaccines experienced a tremendous surge during this period, the share of vaccine-critical contents in these debates remains stable except for a limited number of short periods associated with specific events. Secondly, analyzing the community structure of the re-tweets hyper-graph, we reconstruct the mesoscale structure of the information flows, identifying and characterizing the major communities of users. We analyze their role in the information ecosystem: the largest right-wing community has a typical echo-chamber behavior collecting all the vaccine-critical tweets from outside and recirculating it inside the community. The smaller left-wing community is less permeable to vaccine-critical contents but, has a large capacity to spread it once adopted.