Browsing by Author "Ekström, Anna Mia"
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Item Household food insecurity and its association with self-reported male perpetration of intimate partner violence: a survey of two districts in central and western Uganda(BMJ Open, 2021) Awungafac, George; Mugamba, Stephen; Nalugoda, Fred; Sjöland, Carl Fredrik; Kigozi, Godfrey; Rautiainen, Susanne; Bulamba Malyabe, Robert; Ziegel, Leo; Nakigozi, Gertrude; Kigozi Nalwoga, Grace; Kyasanku, Emmanuel; Nkale, James; Watya, Stephen; Ekström, Anna Mia; Kågesten, AnnaThis study aimed to determine the lifetime prevalence of male-perpetrated intimate partner violence (IPV), and to assess the association with food insecurity, sociodemographic factors and health risk behaviors in Uganda in the year preceding COVID-19- associated lockdowns. Population-based, cross-sectional household survey. Urban, semi urban and rural communities of the Wakiso and Hoima districts in Uganda. Participants A total of N=2014 males aged 13–80 years participated in the survey. The current study included males who reported having ever been in a sexual union and responded to the IPV questions (N=1314).Item Prevalence and risk factors of metabolic dysfunction- associated steatotic liver disease in south Central Uganda: A cross-sectional survey(Wiley Subscription Services, Inc, 2024-04-09) Enriquez, Rocio; Homsi, Mahmoud; Ssekubugu, Robert; Nabukalu, Dorean; Zeebari, Zangin; Marrone, Gaetano; Gigante, Bruna; Chang, Larry W; Reynolds, Steven J.; Nalugoda, Fred; Ekström, Anna Mia; Hagström, Hannes; Nordenstedt, HelenaBackground: Despite numerous risk factors and serious consequences, little is known about metabolic dysfunction-associated steatotic liver disease (MASLD) at population level in Africa. Aim: The aim of the study was to estimate the prevalence and risk factors of MASLD in people living with and without HIV in Uganda. Methods: We collected data from 37 communities in South Central Uganda between May 2016 and May 2018. We estimated MASLD prevalence using the fatty liver index and advanced liver fibrosis using the dynamic aspartate-to-alanine aminotransferase ratio. We collected additional data on sociodemographics, HIV and cardiovascular disease (CVD) risk factors. We used multivariable logistic regression to determine the association between HIV, CVD risk factors and MASLD. Results: We included 759 people with HIV and 704 HIV-negative participants aged 35–49. MASLD prevalence was 14% in women and 8% in men; advanced liver fibrosis prevalence was estimated to be <1%. MASLD prevalence was more common in women (15% vs. 13%) and men (9% vs. 6%) with HIV. Being female (odds ratio [OR] = 2.1; 95% confidence interval [CI] = 1.4–3.3) was associated with a higher odds of MASLD after adjustment for confounders; HIV infection was borderline associated with MASLD (OR = 1.4; 95% CI: 1.0–2.0). Conclusions: In a relatively young cohort in Uganda, 14% of women and 8% of men had MASLD. There was an indication of an association between HIV and MASLD in multivariable analysis. These data are the first to describe the population-level burden of MASLD in sub-Saharan Africa using data from a population-based cohort.Item Qualitative Assessment of Barriers and Facilitators of PrEP Use Before and After Rollout of a PrEP Program for Priority Populations in South‑central Uganda(AIDS and Behavior, 2021) Ddaaki, William; Strömdahl, Susanne; Teresa Yeh, Ping; Rosen, Joseph G.; Jackson, Jade; Nakyanjo, Neema; Kagaayi, Joseph; Kigozi, Godfrey; Nakigozi, Gertrude; Grabowski, M. Kathryn; Chang, Larry W.; Reynolds, Steven J.; Nalugoda, Fred; Ekström, Anna Mia; Kennedy, Caitlin E.Uganda piloted HIV pre-exposure prophylaxis (PrEP) for priority populations (sex workers, fishermen, truck drivers, discordant couples) in 2017. To assess facilitators and barriers to PrEP uptake and adherence, we explored perceptions of PrEP before and experiences after rollout among community members and providers in south-central Uganda. We conducted 75 indepth interviews and 12 focus group discussions. We analyzed transcripts using a team-based thematic framework approach. Partners, family, peers, and experienced PrEP users provided adherence support. Occupational factors hindered adherence for sex workers and fishermen, particularly related to mobility. Pre-rollout concerns about unskilled/untrained volunteers distributing PrEP and price-gouging were mitigated. After rollout, awareness of high community HIV risk and trust in PrEP effectiveness facilitated uptake. PrEP stigma and unexpected migration persisted as barriers. Community-initiated, tailored communication with successful PrEP users may optimize future engagement by addressing fears and rumors, while flexible delivery and refill models may facilitate PrEP continuation and adherence.Item To use or not to use a condom: A prospective cohort study comparing contraceptive practices among HIV-infected and HIV-negative youth in Uganda(BMC Infectious Diseases, 2011) Beyeza-Kashesya, Jolly; Kaharuza, Frank; Ekström, Anna Mia; Neema, Stella; Kulane, Asli; Mirembe, FlorenceUnwanted pregnancy and HIV infection are issues of significant concern to young people. Limited data exists on contraceptive decision-making and practices among HIV-infected and HIV-negative young people in low resource settings with generalized HIV epidemics. From July 2007 until April 2009, we recruited, and followed up over a one year period, a cohort of 501 HIV-negative and 276 HIV-infected young women and men aged 15-24 years residing in Kampala and Wakiso districts. We compared contraceptive use among HIV-infected and HIV-negative young people and assessed factors associated with contraceptive decision-making and use, using multivariate logistic regression modelling to estimate odds ratios (OR) and 95% confidence intervals (CI).